Loading
Form preview
  • US Legal Forms
  • Form Library
  • Social Forms
  • California Social Forms
  • Ca Dc-204w 2014

Get Ca Dc-204w 2014

MAILING ADDRESS TELEPHONE NUMBER CITY STATE ZIP CA Or mail to: Denti-Cal Forms Reorder 11155 International Dr. MS 25 Rancho Cordova, CA 95670 TAR/Claim Forms and Envelope DC-202 TAR/Claim Form (For filling in by hand) DC-209 TAR/Claim Form (For pin-fed printers) DC-217 TAR/Claim Form (For laser printers) DC-206 Envelope (For mailing forms to Denti-Cal) DC-054 Form Justification of Need for Prosthesis DC-007 Envelope (For mailing CIFs and Correspondence) Other Forms and Envelopes DC.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the CA DC-204W online

The CA DC-204W form is essential for users participating in the California Medi-Cal Dental (Denti-Cal) Program. This guide provides a clear roadmap for filling out the form accurately and efficiently online.

Follow the steps to complete the CA DC-204W form.

  1. Click the ‘Get Form’ button to obtain the CA DC-204W form and open it in your preferred digital document management system.
  2. Begin by entering the billing provider's name in the designated field. This should reflect the name under which services are billed.
  3. Provide the NPI or billing number accurately. This number is crucial for billing and identification purposes within the Denti-Cal Program.
  4. Fill in the fax number for submitting reorder requests, ensuring that it is typed correctly to avoid any delays in processing.
  5. Enter the mailing address of the billing provider, including street address, city, state (CA), and ZIP code. It is important for correspondence and document deliveries.
  6. Input the telephone number for the billing provider, as this may be required for follow-up communications.
  7. Review all filled fields for accuracy. Ensuring each section is completed without errors will streamline the processing of your request.
  8. Once satisfied with the information provided, save your changes, and consider downloading or printing the document for your records or for submission purposes.

Complete your documents online now to ensure efficient processing.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Related content

X-57 Electromagnetic Interference Design...
by D Avanesian · 2023 · Cited by 2 — • New PCBs – Power, Driver, AC-DC. • AC and...
Learn more
CSU Buildings and Grounds History: District...
Located at 204 West Lake Street, “District Cooling Utility Plant No. 2” was placed...
Learn more
NES-200 series
DC VOLTAGE. RATED CURRENT. CURRENT RANGE. RATED POWER. OUTPUT. VOLTAGE ADJ. RANGE...
Learn more

Related links form

Your Guide To Legal Fatherhood - Dcf Wisconsin 2020 LOCK BOX AUTHORIZATION ADDENDUM - Rrar Nj Resale Certificate 2020 Vd119 1987

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

Payer ID 84099 is designated for specific healthcare claims, particularly in the dental sector. Knowing this ID is vital when submitting claims to ensure they are processed accurately and quickly. When using the CA DC-204W form, keep this payer ID in mind to lessen any possible delays in receiving payment.

The Denti-Cal number is a unique identifier assigned to dentists and dental providers in California under the Denti-Cal program. This number ensures that providers can bill for services efficiently. If you're navigating the CA DC-204W form, understanding the importance of this number helps enhance your billing accuracy.

CA DC stands for California Department of Consumer Affairs. This department oversees various licensing and regulatory functions, ensuring consumer protection and professional accountability. The CA DC-204W form is crucial for specific applications, providing essential information for your requests.

When filling out city and state for Washington DC, enter 'Washington' as the city and 'DC' as the state. It is important to ensure that the city and state match the address format required for any legal or official documents. Utilizing the CA DC-204W can help guide you in completing forms correctly and fully, minimizing errors in your application process.

The payer ID for Denti-Cal is necessary for submitting dental claims under the Medi-Cal program. This ID allows providers to process claims accurately and efficiently. You can usually retrieve the payer ID through the Denti-Cal provider website or by contacting their support. When filing claims, making use of the CA DC-204W form can streamline the submission process.

Medi-Cal and Denti-Cal both refer to California's Medicaid program, but they target different services. Medi-Cal is the broader term for health coverage, while Denti-Cal specifically covers dental services under the Medi-Cal umbrella. Understanding this distinction helps you navigate the insurance landscape effectively. When dealing with claims, referring to the CA DC-204W form can help clarify the services included.

Cal number is a unique identifier assigned to each MediCal Dental participant. This number is crucial for accessing dental services covered under MediCal. You will need it when submitting claims to ensure accurate billing and prevent delays in processing. Utilizing resources such as CA DC204W ensures that you have all proper documentation ready.

The payer ID for Medi-Cal Dental is essential when processing claims for dental services. It helps identify the services linked to Med-Cal, ensuring they are approved and reimbursed correctly. You can find the specific payer ID on the official Medi-Cal Dental website or through your provider portal. Additionally, using forms like CA DC-204W can simplify the claims process.

The payer ID for Denti Cal is essential for providers submitting claims. Generally, the payer ID is 61012, but it is crucial to verify the current details with Denti Cal directly. Utilizing platforms like uslegalforms can assist you in navigating your forms and claims accurately, ensuring you have the right information at your fingertips.

Yes, many post offices carry common tax forms, including those from the IRS and sometimes state forms like the CA DC-204W. However, availability can vary by location, so it's advisable to check with your local post office. If you need a broader selection, consider visiting libraries or state tax offices for additional resources.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get CA DC-204W
  • Adoption
  • Bankruptcy
  • Contractors
  • Divorce
  • Home Sales
  • Employment
  • Identity Theft
  • Incorporation
  • Landlord Tenant
  • Living Trust
  • Name Change
  • Personal Planning
  • Small Business
  • Wills & Estates
  • Packages A-Z
  • Affidavits
  • Bankruptcy
  • Bill of Sale
  • Corporate - LLC
  • Divorce
  • Employment
  • Identity Theft
  • Internet Technology
  • Landlord Tenant
  • Living Wills
  • Name Change
  • Power of Attorney
  • Real Estate
  • Small Estates
  • Wills
  • All Forms
  • Forms A-Z
  • Form Library
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
  • Real Estate Handbook
  • All Guides
  • Notarize
  • Incorporation services
  • For Consumers
  • For Small Business
  • For Attorneys
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Form Packages
  • Adoption
  • Bankruptcy
  • Contractors
  • Divorce
  • Home Sales
  • Employment
  • Identity Theft
  • Incorporation
  • Landlord Tenant
  • Living Trust
  • Name Change
  • Personal Planning
  • Small Business
  • Wills & Estates
  • Packages A-Z
Form Categories
  • Affidavits
  • Bankruptcy
  • Bill of Sale
  • Corporate - LLC
  • Divorce
  • Employment
  • Identity Theft
  • Internet Technology
  • Landlord Tenant
  • Living Wills
  • Name Change
  • Power of Attorney
  • Real Estate
  • Small Estates
  • Wills
  • All Forms
  • Forms A-Z
  • Form Library
Customer Service
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
Legal Guides
  • Real Estate Handbook
  • All Guides
Prepared for you
  • Notarize
  • Incorporation services
Our Customers
  • For Consumers
  • For Small Business
  • For Attorneys
Our Sites
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
© Copyright 1999-2026 airSlate Legal Forms, Inc. 3720 Flowood Dr, Flowood, Mississippi 39232
  • Your Privacy Choices
  • Terms of Service
  • Privacy Notice
  • Content Takedown Policy
  • Bug Bounty Program
CA DC-204W
This form is available in several versions.
Select the version you need from the drop-down list below.
2017 CA DC-204W
Select form
  • 2017 CA DC-204W
  • 2014 CA DC-204W
Select form