Get the free 837 Dental Companion Document - medicaid alabama
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Alabama Medicaid ANSI ASC X12N
HIPAA Companion Guide for 5010
Standard Companion Guide Communications/Connectivity Information
Instructions related to Transactions based on ASC X12 Implementation
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How to fill out 837 dental companion document
How to fill out 837 dental companion document
01
To fill out the 837 dental companion document, follow these steps:
02
Start by entering the patient's information, such as name, date of birth, and insurance information.
03
Next, input the provider's details, including name, address, and NPI number.
04
Enter the procedure codes and corresponding dates of service for each dental treatment performed.
05
Indicate the submitted charges for each procedure code.
06
Provide any additional relevant information, such as tooth numbers or special instructions.
07
Double-check the accuracy of the filled-out information before submitting the document electronically or by mail.
08
Keep a copy of the completed 837 dental companion document for your records.
09
Note: It is important to follow the specific guidelines and requirements provided by the insurance company and the professional coding standards when filling out the form.
Who needs 837 dental companion document?
01
The following individuals or entities may need the 837 dental companion document:
02
- Dental offices or dental service providers who submit insurance claims for dental treatments.
03
- Insurance companies that require the document for processing dental claims.
04
- Patients who need to provide their dental insurance provider with detailed information about their dental treatments.
05
Keep in mind that the necessity and specific requirements of the 837 dental companion document may vary depending on the insurance company and the nature of the dental services rendered.
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What is 837 dental companion document?
837 dental companion document is a standardized electronic format used for submitting dental claims to insurance companies.
Who is required to file 837 dental companion document?
Dentists, dental offices, and any other healthcare providers who provide dental services and bill insurance companies are required to file 837 dental companion document.
How to fill out 837 dental companion document?
837 dental companion document can be filled out using billing software that supports the 837 format. Providers must input patient information, procedure codes, diagnosis codes, and other relevant details.
What is the purpose of 837 dental companion document?
The purpose of 837 dental companion document is to streamline the billing process for dental services and ensure accurate and timely reimbursement from insurance companies.
What information must be reported on 837 dental companion document?
Information such as patient demographics, provider information, diagnosis codes, procedure codes, dates of service, and charges must be reported on 837 dental companion document.
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