How to Organize Health Records With DA Form 8005-9

Dentists contracting to treat military personnel can expect a good revenue source that comes with lots of paperwork. The military wants dental contractors to use series DA 8005 forms to form the jacket of a dental record. Everything must be filled out properly for billing. Dental office workers dealing with DA Form 8005-9 need to follow the detailed rules on how to complete the jacket and organize the health records that go inside.

Instructions

• 1

  Complete the contents of the Form 8005-9 itself, which should include not only the name and identification of the patient, but information on the contracting party.

• 2

  Insert a properly signed, completed DA Form 5570--automated health history form--in a health questionnaire envelope.

• 3

  Add a signed Privacy Act statement, DD Form 2005.

• 4

  Include next an SF 603/603A, Record of Dental Exam.

• 5

  Insert all supporting radiographs, including panograph and the standard four bitewings that show the conditions before dental work was performed. You will also need to upload all X-rays into the Army or ARNG automated system, as appropriate.

• 6

  Gather copies of all diagnostic quality X-rays to include in the dental record, along with SF 603 and 603A forms. The forms should have all the appropriate officer details including name, rank, treatment, date, information on dental results, and signature of treating dentist. Make sure to upload all of this to the Army or ARNG system, as appropriate, and then include a printout of the entry in the file jacket.