2003 Box 48

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Box 48

Leave blank if dentist or dental entity is not submitting claim on behalf of the patient or insured/subscriber. The individual dentist's name or the name of the group practice/corporation responsible for billing and other pertinent information. This may differ from the actual treating dentist's name. This is the information that should appear on any payments or correspondence that will be remitted to the billing dentist.

 

This information is triggered in the Insurance Plan screen, General tab, Info for Claim (Box 48) field and comes from the Provider Entry screen, Provider Information tab, name and address fields.


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