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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 http://nppes.cms.hhs.gov.
 

SDDA News

Medicaid Reimbursements Increase

The reimbursement rate for the vast majority of dental procedures paid through the state Medicaid Program will increase to approximately 68 percent of commercial rates beginning July 1, 2014.  Increased fees for Medicaid has been a focus of the SDDA's government affairs efforts for the past nine months.  To view the new adult fee schedule click here.  To view the new children's fee schedule click here