pdfFiller is not affiliated with any government organization
Get the 3826 medical form
Form Approved. OMB No. 09600052 SOCIAL SECURITY ADMINISTRATION MEDICAL REPORT (General) See Revised Privacy Act Statement PRIVACY ACT: The Social Security Administration is authorized to collect the
f4 Medical Form is not the form you're looking for?Search for another form here.
Video instructions and help with filling out and completing 3826 medical
Hello and welcome to dendrix desert in this video I'll show you how to attach diagnostic information to procedures to be included with the dental insurance claim this information applies to dendrix G 6.1 and newer first let's verify that we have diagnostic procedure code setup in the system in office manager maintenance practice setup and procedure code setup there are tabs along the top where you can setup various diagnostic codes for this video I'll be focusing on the icd-10 codes these codes were first populated in dendrix G 6.1 and newer by running the CDT 2016 update utility you can of course add the manually to this screen or rerun that utility to make it easy on yourself now I'm going to take a look at the insurance information and specifically the claim format if you'll be electronically submitting your claims then this step really doesn't matter however if you'll be printing your claim the claim format very much matters open the insurance carrier and select the insurance data button the claim format should be set to use the 2012 claim form if you do not see an option to be able to use this form you may need to update your claim format definitions for help with this look in the description of this YouTube video for a link to another how-to video we're ready now to add the diagnostic codes you can complete this step from either the progress notes panel of the patient chart or from the transaction details within the patient's ledger double-click a completed procedure select the diagnosis button from the included diagnostic codes drop-down box choose the code set that you want to use select one or more coats and choose the Add button when you're finished selecting codes choose ok you'll see that the letter D has appeared in the diagnosis area indicating that the procedure has diagnosis attached I'll go ahead now and create the insurance claim and on the insurance information screen I can see that the diagnostic codes are part of this claim remember that the diagnostic codes will be included with the electronic submission I'll go ahead and preview this to show you that these codes will also be included on the 2012 printed claim form and that's how den Trix does it for more tips and training please visit the online resource center you