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DENTAL COMPANION GUIDE to the Health Care Claims Submission ASC X12N 837 (004010×097A1) Implementation Guide March 1, 2004, Table of Contents Introduction...............................................................................................................................................
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How to fill out dental companion guide
How to fill out the dental companion guide:
01
Start by carefully reading through the dental companion guide. Understand the purpose and instructions provided.
02
Begin with filling out the personal information section. This includes your name, contact details, and any other requested information.
03
Next, move on to the dental history section. Provide details about your previous dental treatments, surgeries, or any ongoing dental conditions.
04
Follow the instructions to complete the medical history section. This includes information about your general health, medications you are currently taking, and any allergies or medical conditions you may have.
05
Make sure to accurately document any dental symptoms or concerns you may be experiencing. This will help your dental care provider better understand your needs.
06
If applicable, fill out the insurance and payment information section. Include your insurance details and any payment preferences you may have.
07
Review all the information you have provided to ensure accuracy and completeness. Make any necessary corrections or additions before submitting the form.
Who needs the dental companion guide?
01
Individuals who are visiting a new dental care provider and want to provide a comprehensive history of their dental health.
02
Patients who have recently undergone dental treatments or surgeries and need to provide detailed information to their dental care provider.
03
People with ongoing dental conditions or concerns who wish to keep track of their dental history, symptoms, and treatments.
04
Individuals who have multiple dental care providers and want a standardized way to communicate their dental information across all providers.
05
Dental professionals who are responsible for gathering and maintaining accurate patient records to provide efficient and personalized dental care.
Overall, the dental companion guide serves as a valuable tool for both patients and dental care providers, facilitating effective communication and ensuring thorough understanding of the patient's dental history and needs.
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What is dental companion guide?
Dental companion guide is a tool that assists dental professionals in coding and billing procedures for specific dental treatments and services.
Who is required to file dental companion guide?
Dental professionals, including dentists and dental hygienists, are required to file dental companion guide.
How to fill out dental companion guide?
Dental professionals must accurately document the services provided, diagnosis codes, and treatment codes in the dental companion guide form.
What is the purpose of dental companion guide?
The purpose of dental companion guide is to ensure accurate coding and billing for dental procedures, which helps in proper reimbursement and compliance with insurance regulations.
What information must be reported on dental companion guide?
Information such as patient details, date of service, treatment provided, diagnosis codes, and treatment codes must be reported on dental companion guide.
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