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Wiki Dual credential

lizzard

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Middle River, MD
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A physician is credentialed as a specialist and primary care provider. When seeing patients in our office patients are being charged a specialist co-pay even though they are being seen for a primary care type problem
(say, a rash) Some patients are starting to complain. Is this a potential compliance/audit issue
 
I have a practice with the same issue - you need to set up 2 separate locations for her to use. One for the taxonomy code for her specialty and one for her taxonomy code for her PCP services. That is the only way that the insurances are going to be able to distinguish between what the patient is being seen for. When the front desk is registering or nurse is starting visit note for coding, they need to make sure that they are choosing the correct location for her based on the reason for the patient visit. Hope this helps.
 
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