Effective for claims received on and after August 1, 2008, BadgerCare Plus will accept dental claims submitted only on the American Dental Association (ADA) 2006 claim form. BadgerCare Plus will no longer accept dental claims submitted on the ADA 2000 or 2002 claim forms.
American Dental Association 2006 Claim Form
Effective for claims received on and after August 1, 2008, BadgerCare Plus will accept dental claims submitted only on the American Dental Association (ADA) 2006 claim form. Dental claims submitted on the ADA 2000 or 2002 claim forms will be denied. Providers are reminded to indicate their Medicaid provider identification number on the ADA 2006 claim form until further notice.
Providers may refer to the February 2007 Wisconsin Medicaid and BadgerCare Update (2007-13), titled "New American Dental Association (ADA) Claim Form Available," for ADA 2006 claim form completion instructions and a sample of the ADA 2006 claim form.
Discontinuing the acceptance of older versions of the ADA claim form is in preparation for the implementation of ForwardHealth interChange. Providers may refer to the March 2008 (2008-24) Update, titled "Introducing ForwardHealth interChange, a New Web-Based Information System for State Health Care Programs," for more information about interChange implementation.
Ordering ADA 2006 Claim Forms
Wisconsin Medicaid does not provide the ADA claim forms. Providers may order ADA claim forms by doing one of the following:
- Calling the ADA at (800) 947-4746.
- Ordering forms online from the ADA Catalog on the ADA Web site at ada.org/.
Obtaining a National Provider Identifier
BadgerCare Plus will require all health care providers, including dental providers, to obtain an NPI. Upon full implementation of NPI in October 2008 by BadgerCare Plus, all dentists and dental hygienists will be required to submit only their NPI when conducting business with BadgerCare Plus, even when submitting a paper claim form.
Health care providers who have not obtained an NPI may apply online on the National Plan and Provider Enumeration System (NPPES) Web site at https://nppes.cms.hhs.gov/NPPES/Welcome.do. Providers may also call the NPPES at (800) 465-3203 to obtain a paper application. Refer to the Centers for Medicare and Medicaid Services Web site at cms.hhs.gov/NationalProvIdentStand/ for an overview and more information about how to apply for an NPI.
Providers may refer to the April 2008 Update (2008-30), titled "Implementation of National Provider Identifier," for more information about NPI implementation.
Information Regarding Managed Care Organizations
This Update contains fee-for-service policy and applies to services members receive on a fee-for-service basis only. For managed care policy, contact the appropriate managed care organization. Managed care organizations are required to provide at least the same benefits as those provided under fee-for-service arrangements.
