Fla. Admin. Code R. 69O-161.005

Current through Reg. 50, No. 253; December 31, 2024

Section 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.

Fla. Admin. Code Ann. R. 69O-161.005

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.