Get D1217 2020-2025

The D1217 form is essential for claiming treatment services rendered by a practitioner. This guide will assist you in completing the D1217 online, ensuring you provide all necessary information for payment processing.

Follow the steps to complete the D1217 form online.

1. Click ‘Get Form’ button to access the D1217 form and open it in your preferred editor.
2. Begin by entering the provider details in the designated fields. If the service provider lacks a provider number for the practice address where services were rendered, you may use the provider number from another practice address as a substitute.
3. Fill out all other required sections of the form. Note that the Pathology Inpatient Box should only be completed if all services claimed are inpatient pathology services.
4. Once completed, attach no more than 50 service vouchers to your claim. This ensures your claim is processed efficiently. Ensure that all relevant documents are included, such as D904 Request/Referral.
5. Review the information for accuracy, as this data is crucial for provider verification and the processing of your claim by the Department of Veterans' Affairs.
6. Once you have confirmed that all information is correct, you can save changes, download, print, or share the form as necessary.

Complete your D1217 form online today to ensure prompt processing of your treatment services claim.