alberta dental hygiene claim form

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The Canadian Dental Hygienists Association/ L Association canadienne des hygi nistes dentaires 1122 Wellington St W Ottawa ON K1Y 2Y7 t 613-224-5515 x141 1-800-267-5235 f/t 613-224-7283 NATIONAL DENTAL HYGIENE CLAIM FORM PART 1 - REGISTERED DENTAL HYGIENIST / 17 3 7 17 Last Name First Address Apt. City Province Postal Code Telephone Date of Service D M Y REGISTERED DENTAL HYGIENIST USE ONLY ADDITIONAL INFORMATION OFFICE CDHA UIN 202 CDHA Service Code INTL Tooth Indicate if Preauthorization...
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Instructions and Help about hygiene claim form
So Linda and I are going to do somecharting on a new patient the firstthing we're going to do are put in themissing teeth so Linda are you ready toput in the missing teeth yes I am okaythe first I'm going to do is turn on thesticky switch okay this one over hereokay the patient is missing 132 17 and16 and 8 & 9okay now let's put in some existingconditions a patient has endows on 7 and10 okay and the patient has a crown onnumber 14 and on number 19 there's an MOD amalgamokay and there is an mo composite onnumber 31okay let's put in some treatment for thepatient okay I'll hit the treatment planbutton let's do a bridge from 7:00 to10:00and this to a crown on number 18 andthis to a crown on number three and thisto an mo D composite on number 30and because we have at missing toothnumber 23 we better do a bridge downthere too so let's do a bridge from 24to 22 ok it looks like all our existingrestorations are in there the missingteeth are in there and our treatmentplan is in there so we can see ourtreatment plan down below and we'reready to go to the treatment