I work at a hospital based dental clinic which also has a dental residency program. We are switching from the hospital billing system to Softdent on Monday September 15. During training it came to our attention that the claim forms are generated from the schedule in Softdent. Our current procedure for claims is that all the residents and hygienists are billed under our program director and claims are sent out under his NPI # and license #. With the way Softdent is set up we can have a “billing provider” and a “treating provider”. Our problem is that the residents do not have license numbers but they do have NPI numbers. The hygienists have license numbers but no NPI numbers. The ADA claim form has those fields under the treating provider section. Is it ok to have the resident/hygienist listed on the claim form without having a license number or NPI? I hope you can help us solve this problem as we are going live with the new software on Monday. Thank you for your time and assistance.

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  • I work at a hospital based dental clinic which also has a dental residency program. We are switching from the hospital billing system to Softdent on Monday September 15. During training it came to our attention that the claim forms are generated from the schedule in Softdent. Our current procedure for claims is that all the residents and hygienists are billed under our program director and claims are sent out under his NPI # and license #. With the way Softdent is set up we can have a "billing provider" and a "treating provider". Our problem is that the residents do not have license numbers but they do have NPI numbers. The hygienists have license numbers but no NPI numbers. The ADA claim form has those fields under the treating provider section. Is it ok to have the resident/hygienist listed on the claim form without having a license number or NPI? I hope you can help us solve this problem as we are going live with the new software on Monday. Thank you for your time and assistance.

I work at a hospital based dental clinic which also has a dental residency program. We are switching from the hospital billing system to Softdent on Monday September 15. During training it came to our attention that the claim forms are generated from the schedule in Softdent. Our current procedure for claims is that all the residents and hygienists are billed under our program director and claims are sent out under his NPI # and license #. With the way Softdent is set up we can have a “billing provider” and a “treating provider”. Our problem is that the residents do not have license numbers but they do have NPI numbers. The hygienists have license numbers but no NPI numbers. The ADA claim form has those fields under the treating provider section. Is it ok to have the resident/hygienist listed on the claim form without having a license number or NPI? I hope you can help us solve this problem as we are going live with the new software on Monday. Thank you for your time and assistance.

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Asked on September 10, 2014
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The appropriate way to submit the claim would be to have the attending provider’s information in box 45-52a and the treating/resident/hygienist information placed in box 53-58 of the ADA 2012 claim form.

You may submit the claim with the hygienist or residents NPI number only as long as the attending has both NPI and license number on the claim.

All hygienists and residents need to have an NPI # and may obtain one within minutes at the following website. https://nppes.cms.hhs.gov/NPPES

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Answered on September 11, 2014
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