An associate dentist in your practice performs the treatment. Whose information should appear as the TREATING (rendering) provider when the claim is submitted to insurance?

Correct answer: D. The associate dentist who actually performed the treatment

• A. The tax ID identifies who is paid; it does not replace the requirement to identify the individual who rendered the service.
• B. Choosing a provider on the claim based on which contract pays more is exactly the misrepresentation that constitutes fraud.
• C. The owner may be the BILLING entity, but listing the owner as the treating provider for work the associate performed is a material misrepresentation.
• D. CORRECT. On a dental claim the TREATING/RENDERING PROVIDER must be the dentist who actually delivered the care — here, the associate — including that dentist's own NPI and licence information. The billing entity (practice name, tax ID, billing NPI) can be the owner or the corporation, but the rendering provider field is not interchangeable. Reporting a different dentist as the treating provider misrepresents who performed the service and is insurance fraud.

Note: Source wording was ambiguous ('through the associate insurance'). The examinable principle is: the treating provider on the claim must be the dentist who did the work, regardless of who bills. Worth discussing with the group.