ShauntaEskridge
Guest
I have some concerns about the way the doctor I currently work for is asking me to bill. I bill both professional and Facility claims for him. I need to know if I am within the coding guidelines when billing. We are out of network the provider and the facility. For facility he wants me to bill both 0490 and 0360 together, I’ve explained that we are not affiliated with a hospital so we shouldn’t bill those codes together. He insist and says he get the blow back if it should come back to haunt us not me. We are not certified with Medicare as a facility but we perform surgeries on Medicare patients in this facility. I bill the professional component but not the facility for these patients. I also bill for screws and implants on the professional claim for Medicare patients when they should be billed on facility claims, screws and implants are never paid by Medicare professionally but now I have to “figure” why and when I tell them they say that’s not good enough. We never collect coinsurance for facility. This office is starting to give me red flags and I’m not sure if I should stay here or not. Is it just me or are my suspicions warranted?