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Er facility/dr charges

jgpacheco

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If a doc is employed by a free standing ER facility, should I bill for two different claims? One to reflect the doc charges and then one to reflect Facility charges? Or would it go on just one claim?

Jessica
 

mitchellde

True Blue
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13,298
Location
Columbia, MO
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It depends on where you are and what payer you are billing. There are 2 ways to do this and it is usually payer preference.
1st:
Bill one UB-04 and in addition to the codes for the rev code 450 you add codes for the physician visit and any physician procedures with the rev code for professional services.. I think this is 981 but please look it up first.
or
2nd:
Bill a UB-04 for the facility charges and a CMS 1500 for the professional services.
Most payers that I have dealt with recently want two separate claims but I still occaisionally run across those that want only the UB-04.
 
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