Forms & publications

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Access to Baby and Child Dentistry (ABCD) Billing Guide (2014-07-01)

Instructions for billing for services provided to Washington Apple Health clients.

Provider billing guide

ADA dental attachments submission cover sheet

Use this form when submitting supporting documentation for dental claims.

Form

Agreement of Acceptance (partial denture)

13-965

Complete this form when provisioning all partial dentures.

Form

Budget changes access to dental services

Budget change access to dental services for some clients 2011

Publication

Dental fee schedule (2017-07-01)

Use this fee schedule for dental services effective July 1, 2017

Fee schedule

Dental tooth, arch, and quad numbering

70-351

Instructions on dental tooth, arch, and quad numbering.

Publication

Dental-Related Services Billing Guide (2013-05-01)

Instructions for billing for services provided to Washington Apple Health clients.

Provider billing guide

Denture agreement of acceptance

13-809

Denture agreement of acceptance form which must be completed upon date of delivery.

Form

Denture/partial appliance request

13-788

For skilled nursing facilities clients.

Form

General Information for Authorization

13-835

Use this form (13-835) to submit an initial authorization request.

Form

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