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Wiki mid-levels and commercial ins's??????????

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chicad

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Our office has 2 NP's and 2PA's. I understand the incident-to guidlines for Medicare/Trailblazers, but my situation is this.......

Say for example my PA is seeing a patient for a follow-up visit totally on their own with-out any supervision. The insurance is Blue Cross. I know BC will not accept the PA's name on the claim and it will need to have a physicians name. IF the patients treating physician is not present in the office. Should we still bill under the name of the physician who initially treated the patient (who isnt in the office) or should we bill under an actual physician who was present in the office?
 
We are having a lot of issues with our PAs and the Blue carriers. Based on the way they had us credential them, our understanding was no matter who was there they were to be billed under the provider they are credentialed under.

I have 5 PAs and 2 surgeons, all 5 of the PAs work with both surgeons but we had to assign them to just 1. It is very confusing and we continue to get rejections and have had to go thru the credentialling process 3 times in the past 6 months. I still don't know if it is fixed.

I know this isn't much help but at least you know you aren't alone.

Laura, CPC
 
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