As easy as one-two-three: reflecting on provider numbers BY DR ANNALENE WESTON
The announcement that dental hygienists, dental therapists and oral health therapists would be able to apply for a provider number and claim directly for services provided under the Child Dental Benefits Schedule (CDBS) seems like it happened a long time ago, but is now just around the corner, with a planned commencement date of 1 July 2022. Many of us interface with dental hygienists, dental therapists and oral health therapists in our daily practice, whether as practice owners or associates, and e. Even if we don’t directly, it’sis important to have an understanding of this change,and this is. This also presents a good opportunity to reflect on use of provider numbers in general terms. Provider numbers are, in essence, a site-specific fee-claiming mechanism. In relation to the upcoming changes, the CDBS services that can be claimed will be dependent on what registration is held by the individual hygienist, dental therapist and oral health therapists with the Australian Health Practitioner Regulation Agency. From 20 June 2022, hygienists, dental therapists and oral health therapists will be able to apply to Services Australia for a provider number. As the commencement date approaches, further information will be provided to the professions on the changes and the Services Australia process to apply for a provider number. Information on how to apply for a Medicare provider number is available in resources on the Services Australia website1. There are also training resources on compliance and auditing requirements under the Child Dental Benefits Schedule. It is important to note that applying for an individual provider number is optional. If the hygienist/dental therapist/oral health therapist is currently billing under a dentist’s provider number for the CDBS, they can continue with these arrangements after 1 July 2022.
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EDITION 4 | 2022 WESTERN ARTICULATOR
The Department of Veterans Affairs has informed that there is no immediate plan to provide dental hygienists, dental therapists and oral health therapists direct access to the DVA Dental Program via the new provider numbers. On the face of it, something so relatively simple should not be contentious, and yet we see an alarming number of cases relating to the inappropriate use of a provider number. . With the advent of this change we wanted to highlight some of the risks relating to use/misuse of provider numbers in Dental dental practisece, in the hope that we can raise awareness of the potential issues involved.
CASE STUDY Dr W was a recent graduate and looking for a permanent practice role. He had given a lot of consideration about the type of practice he wanted to work in and was seeking a group practice with plenty of other practitioners as he was concerned about professional isolation. Dr W was keen to be surrounded by likeminded colleagues to enable him to develop and grow. The practice did not have a principal dentist, but rather a ‘flat hierarchy’ of practitioners and a non-dentist practice owner. On assessment, Dr W formed the view that the contract seemed fair, and the practice seemed reasonably well equipped. The other dentists were all welcoming and said that they had a good flow of patients, particularly new patient examinations, so made a good income. He took the job. For the first few weeks, he kept a tight eye on his billings, and indeed, he had a steady flow of patients and a good income. With the passage of time, Dr W became more relaxed at the practice, as he was happy there, and had formed good relationships with both colleagues and patients alike. He was surprised to receive a letter from the Health Fund, stating that he was an outlier and requesting validation for the number of codes charged per patient, and the number of five surface fillings. The five-surface
