Accident & Related Dates - Dental

The Accident and Related Dates section displays information about the causes and dates relating to the claim. The Accident and Related Dates fields are defined by section below :

 

 

If Accident

Related Cause 1 & 2Related Cause 1 & 2

Select the related cause from the drop-down menu. Options are:

AA Auto Accident
EM Employment
OA Other Accident

 

Accident DateAccident Date

Date of the accident related to charges or to the patient's current condition, diagnosis, or treatment referenced in the transaction.

 

 

Auto Accident

StateState

State or Province where auto accident occurred.

 

CountryCountry

Country where auto accident occurred.

 

 

Related Dates

Appliance PlacementAppliance Placement

Date orthodontic appliances were placed.

 

ServiceService

Date when service was performed.

 

Repricer ReceivedRepricer Received

Date the claim was received by the repricer organization.

 

 

 

 

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