Fla. Admin. Code Ann. R. 69O-161.005 - Use of Dental Claim Form
All companies writing dental insurance shall accept Form HCFA 1500 (12/90) and the American Dental Association Dental Claim Form (Form J510, J511, or J512) (1/94). For informational purposes only, the Florida Medicaid dental program shall accept the Non-Institutional Dentist Claim Form (Form 111) (1/89) and Form HCFA 1500. All said forms are hereby incorporated and made part of this rule chapter by reference.
Notes
Rulemaking Authority 624.308(1), 627.647 FS. Law Implemented 624.307(1), 627.647 FS.
New 6-8-94, Amended 12-5-95, Formerly 4-161.005.
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