Important News Regarding Your NPI Identifier

 

A recent article that appeared in the ADA News (4/10/08) noted that the ADA's Department of Dental Informatics is advising all dentists to obtain a National Provider Identifier, whether or not they submit claims electronically.

There are a number of reasons why it makes all the sense in the world to obtain one, not the least of which is for the convenience of your patients.  The example cited involves your Medicare or Medicaid patients who may require a prescription after dental treatment.  While you may not file a dental claim electronically, pharmacies fulfilling a dentist's prescriptions ARE required to submit the NPI number of the prescriber (ie, you) if they are to get paid by the patient's prescription drug benefit administrator.  While initially the pharmacist's problem may not matter to you, your patient may be inconvenienced if they have to pay out of pocket for a prescription you wrote that might otherwise be a covered benefit!

 

  • If you already have an NPI number, great.  You're ahead of the game.
  • If not, get one by simply going online for an application form at https://nppes.cms.hhs.gov/, or call 1-800-465-3203.

 

And for those of you who may find it necessary to write a prescription for a Medicare or Medicaid patient, you should either write or stamp your NPI number on your New York State prescription forms.  Second District has been advised by Mr. Lawrence Mokhiber, Acting Executive Secretary of the State Board for Dentistry that within 6 months, provisions will be made for you to have your NPI number recorded on your newly ordered Official New York State Prescription forms.

 

The National Provider Identifier Regulations

 

The National Provider Identifier is a 10-digit number issued by the government which serves as a unique identification number for healthcare providers. If you are a dentist who uses standard electronic transactions, i.e. eligibility verifications, electronic claims, claims status inquiries and claim attachments, federal law requires you to obtain an NPI and begin including it on those transactions no later than May 23, 2007. You are not required to use an NPI if you do not utilize electronic transactions. However, you may still want to apply for one so that you're prepared if the federal government extends the regulation to include paper-based transactions or if health plans begin requiring the use of NPIs on paper claims. The NPI does not replace DEA, license or Tax ID numbers.

Applying for an NPI is FREE and can be done electronically or by mail. To apply online, visit the website for the National Plan & Provider Enumeration System (NPPES) at http://nppes.cms.hhs.gov/ , and complete the 20-30 minute application process. If you prefer to apply by mail, simply download the application form, complete it and mail it to the NPPES. For more information on NPIs visit the American Dental Association website at http://www.ada.org/. As always, the staff at Second District Dental Society is available to answer any specific questions you may have about this issue.