Wiki Dr Is OON and out of town

[Dipstyck]

Question I have a provider who is out of network with an insurance company. He is currently on vacation for the next two weeks. My patient requires an infusion. Is there a way to build this under the provider that is away when one of his partners is seeing the patient. Is there a modifier that we should be using as the authorization is under this out of network provider?

 

[JDACPC]

You may be thinking of a locum scenario where visits can be billed under the vacationing MD with a GC modifier. HOWEVER, this is NOT that scenario if it is a partner in the same group practice/specialty. Providers in the same group practice/specialty are considered one entity/provider so there should be no issues billing under the partner per usual. The authorization should also be valid for either provider in the same group.

 

[Dipstyck]

Thank you so much for answering, i never got a notification prior so I never responded. Thank you so much!