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Regulatory & Compliance : National Provider Identifier

National Provider Identifier (NPI)

Anyone who uses standard electronic transactions, like electronic claims, eligibility verifications, claims status inquiries and claim attachments, is required by federal law to use NPIs on all electronic transactions. In addition, those dentists who use only paper, voice and fax to transmit these communications may find NPIs useful or necessary for other reasons. The ADA encourages all dentists to obtain and use a NPI, particularly those using (or planning to use) electronic transactions. The NPI will replace other identification numbers issued by health plans and will be required for electronic transactions and, at insurers' discretion, for paper transactions. Dentists can apply online at https://nppes.cms.hhs.gov/NPPES/Welcome.do .
 

SDDA News

Dentists Enroll in Medicare?
 
Most dental services are not covered by Medicare; therefore, most dentists are not enrolled in Medicare. However, to ensure that patients on Medicare receive the services and supplies ordered for them by their dentist, SDDA members should enroll In Medicare.  Dentists may utilize a simplified process of enrollment in Medicare because the dentist will not be directly billing Medicare. Members should enroll by filling out short form: CMS-855-O and mailing it to South Dakota's Medicare administrative contractor:
Noridian Healthcare Solutions

PO Box 6733

Fargo, ND 58108-6707
 
For more information on why dentists need to enroll, or opt, out of Medicare go to http://success.ada.org/en/
 
 

Mouth Healthy