2024 ADA Dental Claim Form

Did you know that the ADA Dental Claim Form has been revised for 2024? The new form includes additional fields to record treatment provided by a “locum tenens” dentist; a patient’s last scaling and root planing dates; and third-party payer ID fields. Additional information is available on the ADA’s website; ADA Dental Claim Form | American Dental Association.

View a video outlining the changes; https://www.youtube.com/watch?v=cFXN8jp_E9M 

To purchase and download a pdf version of the claim form: Dental Claim Form (2024 Version) Downloadable PDF - American Dental Association