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Ohio Laws and Rules
(A) The Ohio state dental board hereby prescribes that the written work authorization required in division (B) of section 4715.09 of the Revised Code shall be on printed forms for both original and copy and shall contain the following:
(1) The name and address of the entity or person to whom the written work authorization is directed.
(2) The patient’s name and/or identifying number. In the event such identifying number is used, the name of the patient shall be written upon a copy of such written work authorization retained by the dentist.
(3) A description of the work to be done, with diagrams if applicable.
(4) A description of the type of the materials to be used.
(5) The actual date on which the authorization was written.
(6) The signature in ink by the dentist issuing the said written work authorization, his state dental license number and his office address.
(B) The dentist shall retain a copy of the written work authorization for two years from its date as a part of the patient record.
(C) The unlicensed person, partnership, association, or corporation shall retain the original work authorization for two years from its date.
(D) If the unlicensed person, partnership, association, or corporation receiving a written work authorization from a licensed dentist engages another unlicensed person, partnership, association, or corporation (herein referred to as “sub-contractor”) to perform some of the services relative to such work authorization, as provided for in division (C) of section 4715.09 of the Revised Code, he or it shall furnish a written sub-work authorization with respect thereto on forms which shall contain the following:
(1) The name and address of the sub-contracting entity or person to whom the work authorization is directed.
(2) A description of the work to be done, with diagrams if applicable.
(3) A description of the type of materials to be used.
(4) The actual date on which the written work authorization was written to the sub-contractor.
(5) The name, address, and signature of the entity or person issuing the sub-work authorization
(E) The sub-contractor shall retain the original sub-work authorization and the entity engaging the sub-contractor shall retain a duplicate copy of the sub-work authorization, attached to the written work authorization received from the licensed dentist, for a period of two years.
(F) All written work authorizations and sub-work authorizations required by paragraphs (B), (C), and (E) of this rule, held by the dentist or unlicensed person, partnership, association, or corporation shall be open for inspection without a subpoena for two years by the state dental board, its authorized agents, or the prosecuting attorney of a county or the director of law of a municipal corporation wherein the written work authorizations or sub-work authorizations are located.
(G) The Ohio state dental board hereby prescribes that the demand for a written work authorization in division (D) of section 4715.09 of the Revised Code, be made in writing. The unlicensed person shall retain a copy of the original written demand for a written work authorization form for a period of two years. Copies of work authorization form demands shall be open for inspection by the Ohio state dental board and its investigators.
(H) The foregoing does not prohibit the inclusion of additional information on the written work authorization when the same is necessary or desirable.
(I) “Unlicensed person, partnership, association or corporation” as used in this rule, includes, but is not limited to, dental laboratory or dental laboratory technician.
HISTORY: Eff 9-30-70; 4-27-98; 5-15-03
Rule promulgated under: RC 119.03
Rule authorized by: RC 4715.03
Rule amplifies: RC 4715.09
R.C. 119.032 review dates: 01/13/2003 and 05/14/2008