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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

ADA Guidance on Coordination of Benefits

With the passage of the Affordable Care Act, more consumers are able to purchase dental plan coverage in their medical plans creating questions with respect to coordination of benefits (COB). The ADA has created guidelines to help member dentists and their staff coordinate the dental benefits of their patients.  The ADA's guidelines are available as a members-only resource on the Center for Professional Success website at Success.ADA.org/COB.

 


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