ComplyRight ADA Dental Claim Forms (2024 Version), Laser, 8-1/2in x 11in, Box Of 2, 500 Forms MPN:20241

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In Stock
Brand: R & R
Part #: 20241
UPC: 790757381674
SKU
312-6820753
$119.29

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ComplyRight ADA Dental Claim Forms (2024 Version), Laser, 8-1/2in x 11in, Box Of 2, 500 Forms MPN:20241

Streamline your dental billing process with ComplyRight's 2024 ADA Dental Claim Forms. These laser-printed forms adhere to strict standards and are 100% compliant with ADA guidelines, ensuring accurate and timely reimbursement. With new spaces for reporting specific data, you can expedite claim reimbursement and clearly identify claims for locum tenens services. The forms also support reporting Payer ID, uniquely identifying third-party payers. Use these forms to bill patients' insurance companies for reimbursement of dental claims, promoting efficient and compliant billing practices in your dental practice. Perfect for dentists and dental offices seeking to simplify their billing process.

Top product features:

  • Acid Free: Yes
  • Carbonless: Yes
  • 100% compliant to meet ADA guidelines

Top product applications:

  • Office Supplies
  • Medical Billing
  • Dental Office
As of January 1, 2024, the ADA released an updated version of the ADA Form that now provides new spaces for reporting specific data that can expedite timely and accurate claim reimbursement. The 2024 version also makes it now possible to clearly identify claims for services delivered by a locum tenens" dentist, one who is standing in for another who is away from the practice for a short time. The form also supports reporting an identifier, known as Payer ID, that when available uniquely identifies the third-party payer receiving the claim. ComplyRight Dental Claim Forms allow healthcare providers to bill a patients insurance company for reimbursement of dental claims. These forms have accurate content and conform to the Health Insurance Portability and Accountability Act (HIPAA). Developed in conjunction with all the governing agencies, including the National Uniform Claim Committee (NUCC), the National Uniform Billing Committee (NUBC), the CMS Centers for Medicare and Medicaid Services, the Health and Human Services Agency, and the American Hospital Association. The ADA Form provides a common format for reporting dental services to a patients dental benefit plan. ADA policy promotes use and acceptance of the most current version of the ADA Dental Claim Form by dentists and payers. The following materials are prepared by the ADA Practice Institute staff with contributions from the ADA Council on Dental Benefit Programs and other internal and external knowledge experts. The form also supports reporting an identifier, known as Payer ID, that when available uniquely identifies the third-party payer receiving the claim. Forms adhere to strict printing standards that govern the layout, paper and ink. 100% compliant to meet ADA guidelines. Laser Form 8-1/2in X 11in

Features

  • Acid Free: Yes
  • Binding Type: Cut-Flush
  • Brand Name: ComplyRight
  • Carbonless: Yes
  • Claim Type: ADA Dental
  • Color (Ink): Black
  • Double Sided: Yes
  • Manufacturer: R & R VENTURES
  • Number of Parts: True
  • Quantity: 2500
  • Sensor Bars: No
  • Sheet Size: Letter (8-1/2" x 11")
  • Total Quantity: 2500 Medical Claim Forms

Additional Information

  • Country of Origin: US
  • UNSPSC Code: 14111810
  • UNSPSC Commodity: Personnel forms or personnel books
  • Green: No
  • Recycled Content: FALSE
  • Hazardous: No
  • Prop 65: No
  • MSDS URL: nan
  • Package Length: 11.00
  • Package Width: 8.50
  • Package Height: 5.00
  • Package Weight: 8.00
Product info last updated on February 13, 2026 2:08am UTC Category: Business Forms and Bookkeeping
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In stock