Protect your provider number

8 February 2019

As a registered dentist, you are recognised under the Health Insurance (Dental Services) Determination 2007 for the purposes of Medicare.  

As such you are provided with a Medicare Provider Number for the purposes of claiming a Medicare Benefit for eligible treatments you provide. Your provider number is unique to you and the location at which you practice. If you practice at more than one location, then you need a provider number for each location. 

There are a few key things to know about having a provider number which seems to be misunderstood by some practitioners. 

First and foremost, you can’t use anyone else’s Medicare provider number under any circumstance. So, it follows that no‑one else can use yours! However, there are some circumstances where services can be provided on your behalf and a claim made using your provider number by dental hygienists, dental therapists and oral health therapists. These include: 

Child Dental Benefits Schedule 
The dental practitioner must perform all services in accordance with accepted dental practice. This includes any supervision requirements. 

Department of Veterans’ Affairs 
Dental Hygienists, dental therapists and oral health therapists may also provide services to eligible DVA cardholders on behalf of a dentist. 

Private Health Insurance 
Similarly, if hygienists or therapists are providing services on your behalf and the patient is in a health fund, your provider number can be used for claiming purposes but only if you have approved/have oversight of the treatment provided. 

Use of provider numbers when fulfilling a locum position is another area where there seems to be some confusion. A locum is a provider who temporarily fulfils the duties on behalf of a provider in a practice. The locum needs to ensure that their provider number is used on patient accounts, not another provider’s allocated number. 

If you are fulfilling a locum position of less than two weeks, you are allowed to use your provider number from another location. If you will be in the locum position for more than two weeks or intend to practice at the new location more than once, you should apply for a provider number for the relevant location. 

When leaving a place of employment, it is essential that you advise Medicare and cancel your provider number for that location. 

If you have any further questions, please don’t hesitate to get in touch with your local branch for further advice.