Monday, October 24, 2011

Type I or Type II NPI - What's the Difference?

Ok, let’s turn up the volume in the excitement department and talk about something that I know everyone is on the edge of their seats about.  What?  You don’t want to talk about Government mandated provider numbers?  Hard to believe, but let’s talk NPI types anyway, because it is important.  You might be surprised how many offices I encounter that are not billing correctly, because they have misunderstood these type codes.
When I am working with a new Dentrix office setting up the provider numbers   is a routine part of determining the basic information to include on the dental claim form.  But what about all you existing Dentrix users?  I worry about all the sleep you are losing, wondering what a Type II NPI number even is and where it goes on the dental claim form. 
In layman’s terms, a Type II NPI number is used if the dentist or dental office is a corporation.  If your office files taxes as a corporation (and not as a sole proprietor), then you need to have a Type II NPI number.  If you don’t know – just ask the office’s accountant, you’ll make his or her day.
If your office files taxes as a corporation, then your dentist will have his personal Type I NPI and you will also have a Type II NPI for the organization.  If you need to apply for a Type II NPI you can go to the National Plan & Provider Enumeration System (NPPES) to apply.  CLICK HERE to be directed to the NPPES application page.
Once you have received your Type II NPI number,  it only takes a couple quick steps to set it up in your Dentrix software.  First, from the Office Manager go to Maintenance > Practice Setup > Practice Resource Setup.  This will open up the page with all your providers.  You will need to create a new provider for the corporation and enter the new Type II NPI number here.

Next, from the Office Manager go to Maintenance > Practice Setup > Practice Defaults.  This will open the page where you will point the Billing and the Pay-To Provider to the new Corporation so the Type II NPI number will print in the correct fields on the dental claim form. 

So, there you have it – the basics you need to know  on NPI types.  Now we can all relax knowing we’ve put this important little tidbit to rest, and we can all move on to a topic more exciting than government regulations.  I promise.


Dayna Johnson, Certified Dentrix Trainer
Dayna loves her work. She has over 25 years of experience in the dental industry, and she’s passionate about building efficient, consistent, and secure practice management systems. Dayna knows that your entire day revolves around your practice management software—the better you learn to use it, the more productive and stress-free your office will be. In 2016, Dayna founded Novonee ™, The Premier Dentrix Community, to help cultivate Dentrix super-users all over the country. Learn more from Dayna at www.novonee.com and contact Dayna at dayna@novonee.com.


2 comments:

  1. Hi!
    I am confused, in my case my dental office is an LLC and I only have 1 NPI type I for Doctor...Do I still need to get a NPI type II? or only will apply when I bill to the dental insurance with different providers under my Dental Office name,
    Example: when I received the payments from insurance the name is the office LLC but I do not have the NPI # for this company only the Tax Id# ?
    Can you pls let me know Do I still need a NPI# type 2?
    Thank you,

    ReplyDelete
  2. Hello,

    When NPI numbers first came any provider that was a corporation needed to apply for a Type II NPI number however in the final rule it is now up to the provider. Here is a link that might help answer your question.

    https://questions.cms.gov/faq.php?id=5005&faqId=2511

    Thank you,
    Dayna

    ReplyDelete