What form is used when a dental provider bills for dental procedures rendered?

• A. Dental claim form
• B. Patient intake form
• C. Treatment plan
• D. Insurance claim form

Answer: (A)

When a dental provider bills for procedures that were rendered, the document used is the dental claim form. This form captures the patient and provider information, dates of service, and the codes that describe each procedure performed, and it is submitted to the payer to request payment for those services.

An intake form is used to collect patient information before treatment, not to bill for services. A treatment plan outlines the recommended procedures and expected costs before treatment takes place. An insurance claim form serves a similar purpose in requesting payment from an insurer, but in dentistry the standard term for the billable document that details the actual rendered services is the dental claim form.