Attention: Dental and Orthodontic Providers Important Guidance re: Time Limit Override and Adjustment Requests for Dental Claims

Based on guidance from the N.C. Division of Medical Assistance (DMA), when Dental providers submit Medicaid Resolution Inquiry Forms (for Time Limit Override requests) or Medicaid Claim Adjustment Request Forms, the ADA paper claim that is submitted with the form must have the Billing Provider taxonomy code entered into Field 35 ("Remarks") on the claim. Without the Billing Provider taxonomy code in Field 35, the request will be denied. Requests previously denied for this reason should be resubmitted with the Billing Provider taxonomy code in Field 35 of the ADA paper claim, as well as the appropriate completed form and supporting documentation.