Wiki Mid Level Billing

[DeannaAnderson]

We are doing some billing for a Large Pharmacy Facility. We are receiving scripts from a Mid Level Practitioner (PA, NP's) who are within the group practice. Although the midlevels have NPI's we are trying to determine whose NPI's should be listed on the claims. Should it be the Supervising Physician or should it be the Mid level's information?

 

[jbrashear]

The rules may be different for a pharmacy facility, but in a clinic, if an NPP has their own NPI, then the claim is billed under that. The only time we bill under a Supervising Physician is when the NPP is not credentialed with a particular insurance company. It also depends on the facility's organization. Some facilities are organized in a way that everything is billed under a supervising physician, others don't.

Like I said though, a pharmacy facility may work under different regulations, these are just my thoughts.