Queizati
Networker
Hi all,
Are there any circumstances in which a hospital outpatient campus would bill a place of service on a claim dependent upon what type of insurance the claim is being billed out to?
Our facility utilizes provider based billing, POS 19, for Medicare/Medicaid/managed plans and POS 11 for commercial insurances.
Our physician is performing E/M visits with the PA and we are unsure if split/shared rules apply for the commercial insurances since the service is still physically being conducted in a outpatient facility it’s just the claim is using POS 11; which would take precedence in terms of following split/shared guidelines?
Are there any circumstances in which a hospital outpatient campus would bill a place of service on a claim dependent upon what type of insurance the claim is being billed out to?
Our facility utilizes provider based billing, POS 19, for Medicare/Medicaid/managed plans and POS 11 for commercial insurances.
Our physician is performing E/M visits with the PA and we are unsure if split/shared rules apply for the commercial insurances since the service is still physically being conducted in a outpatient facility it’s just the claim is using POS 11; which would take precedence in terms of following split/shared guidelines?