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MEMORANDUM TO NHS: PCA(D)(2022)2 DENTISTS/DENTAL BODIES CORPORATE NATIONAL HEALTH SERVICE GENERAL DENTAL SERVICES AMENDMENT NO. 155 TO THE STATEMENT OF DENTAL REMUNERATION Determination XIII Recruitment
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Step 1: Contact your dental service provider and request a personal dental services statement form.
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Step 2: Fill out your personal information including your name, address, contact information, and insurance details.
03
Step 3: Provide details of the dental services you have received, including dates of service, type of procedure, and cost incurred.
04
Step 4: Review the completed form for accuracy and sign the statement to verify its authenticity.
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Step 5: Submit the completed personal dental services statement to your insurance provider or employer as needed.

Who needs personal dental services statement?

01
Individuals who have received dental services and need to report it for insurance claims or reimbursement purposes.
02
Employers who offer dental benefits to their employees and require documentation of services rendered.
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Insurance companies who need verifiable records of dental treatments for coverage determination.
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Personal dental services statement is a form that dental professionals need to file to report their dental services provided to patients.
Dental professionals such as dentists, dental hygienists, and dental assistants are required to file personal dental services statement.
Personal dental services statement can be filled out online or on paper, where dental professionals need to provide information about the services they have provided to patients.
The purpose of personal dental services statement is to ensure transparency and accuracy in reporting dental services provided by dental professionals.
Information such as patient demographics, services provided, fees charged, and any reimbursements received must be reported on personal dental services statement.
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