Billing for non-credentialed physician

lmfort

Networker
Messages
44
Best answers
0
Help please! We have a new physician starting in early August. The new physician will be graduating end of July. I've been told that the credentialing process cannot start until after graduation. If the new physician sees patients beginning in early August, can those visits be billed under an established, credentialed physician in our office? If so, is there a specific way to note this on the claim? Is there a modifier to use? Does the established, credentialed physician have to see the patient also and/or sign-off on the office note? If this is not appropriate, can you point me to documentation to give to the physicians? Our office has worked with a PA in the past but never a new physician straight from graduation. Any advice is welcome. Thank you in advance.
 

mitchellde

True Blue
Messages
13,506
Location
Columbia, MO
Best answers
2
you cannot bill one physician using the NPI of another as in incident to. If the provider is not credentialed then you will need to wait until that is done or the visits will be out of network.
 

sne264

Guest
Messages
3
Best answers
0
Sharon Billing Manager

I cannot find documentation to confirm this but I know at one time I found it..This is something always asked. Can anyone provide the website link for this? Thank you
 

avon4117

Guru
Messages
244
Location
FLINT
Best answers
0
when completing the credentialing paperwork make sure you put the first day of employment..they normally would retro it back to that date once the paperwork is complete...you can then rebill the PA charges once the credentialing process is complete. You will have to bill under the PA for now.
 
Last edited:
Top