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Diplomate of the American Board of Periodontology Sarmad Paydar, D.D.S., M.S. Ramsen Warda, D.D.S. First Available 1631 Creekside Dr. Ste 103 Folsom, CA 95630 Tel: (916) 9848404 Fax: (916) 9849308
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Start by gathering all the necessary information and documents required to fill out the 85655 golden state dental form.
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Begin by entering your personal information, such as your name, address, and contact details.
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Provide your dental insurance information, including the policy number and group number.
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Fill out the details of any additional coverage you may have, if applicable.
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If you are the primary policyholder, provide information about any dependents covered under your plan.
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Enter details of the dental service received, including the date, provider name, and procedures performed.
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Who needs 85655 golden state dental?

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85655 golden state dental is needed by individuals who have dental insurance coverage under the Golden State Dental plan.
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85655 Golden State Dental refers to a specific dental claim form used by dental service providers in California to submit claims for reimbursement from dental insurance carriers.
Dental providers and practitioners who provide services covered by dental insurance are required to file the 85655 Golden State Dental form to ensure proper reimbursement.
To fill out the 85655 Golden State Dental form, dental providers must include patient information, details of the services provided, treatment codes, and any necessary supporting documentation as specified by the insurance carrier.
The purpose of the 85655 Golden State Dental form is to facilitate the billing process between dental service providers and insurance companies, ensuring that providers receive payments for services rendered.
Information that must be reported on the 85655 Golden State Dental form includes patient identification, diagnosis codes, procedure codes, dates of service, and provider details.
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