I could really use some feedback/ideas regarding billing as individual vs group and with multiple locations. We are a group practice and we have multiple physicians who are all hospital based. We provide services at multiple hospitals in 2 states. Some of our doctors provide services in BOTH states, but most practice in one state or the other. Right now we have 1 group name, 1 NPI and 1 tax ID #.
Basically I have 3 questions. 1. Since we are a group -- and the physicians are employed by the group, are we REQUIRED to submit claims as a group .. and bill each doctor as the rendering provider.. or can we bill some plans as individual physicians? I'm thinking it HAS to be billed as a group... but I'd like to know if the other option is ok.
2nd: Right now we have 3 separate hospitals where we provide services. 2 hospitals in the same city and another in a different state. What are the benefits/drawbacks of having multiple NPI numbers for the group?? (I know each DOCTOR can only have 1 NPI, but groups can have more). What about the TAX ID? would it need to be different??
3rd: I'm having difficulty with one of my plans at the moment regarding contracting. They are saying we need separate contracts for each location (hospital)? It's a medicaid plan that still assigns a unique medicaid provider number for each service location. Does anyone else have doctors that see patients at several hospitals? Do you have to have a different contract or ID number for each hospital? I can understand if you have multiple offices, but at every hospital? We put the hospital name, address and NPI in box 32 of the HCFA, so I thought that would be enough. Maybe not??
I would really appreciate any ideas/ thoughts or feedback on any of these 3 questions.
Basically I have 3 questions. 1. Since we are a group -- and the physicians are employed by the group, are we REQUIRED to submit claims as a group .. and bill each doctor as the rendering provider.. or can we bill some plans as individual physicians? I'm thinking it HAS to be billed as a group... but I'd like to know if the other option is ok.
2nd: Right now we have 3 separate hospitals where we provide services. 2 hospitals in the same city and another in a different state. What are the benefits/drawbacks of having multiple NPI numbers for the group?? (I know each DOCTOR can only have 1 NPI, but groups can have more). What about the TAX ID? would it need to be different??
3rd: I'm having difficulty with one of my plans at the moment regarding contracting. They are saying we need separate contracts for each location (hospital)? It's a medicaid plan that still assigns a unique medicaid provider number for each service location. Does anyone else have doctors that see patients at several hospitals? Do you have to have a different contract or ID number for each hospital? I can understand if you have multiple offices, but at every hospital? We put the hospital name, address and NPI in box 32 of the HCFA, so I thought that would be enough. Maybe not??
I would really appreciate any ideas/ thoughts or feedback on any of these 3 questions.