Wiki New Patient help

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lcouto

Networker
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77
Location
Stuart, FL
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If a New Self Referred Patient comes in to see our doctor the doctor doesn't want his name listed as the referring physician... Our practice has billed it that way in the past but since he has brought this up our IT created a self referred category but has had to put all 9's in for the NPI # so when it reaches the insurance company it is being rejected because of this... My question is does there have to be a referring physician on a self referred new patient and if so any suggestions on how to bill these?
 
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I don't know of any insurance company that requires a referring physician on an office visit, so it can be blank. However, why on earth does your provider think it matters?
 
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By definition, a self referred patient is not referred by any provider because the patient is referring him/herself. As the other two posters explain, there is no provider to enter as a referring provider. I am also curious to know why your provider feels they must put someone in as a referring provider? Perhaps this is the way your EHR is setup? If so, I am sure your IT crew can reprogram that function, as revenue cycle-wise it makes no sense to force enter information that you don't have, especially since you are having problems with the bogus NPIs entered by this situation.

Hope this helps!
 
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Thank you so much... Yes our system was set up with this being a required field.. The provider who brought it to our attention doesn't feel his name should be in the referring since he didn't refer them... We all know how they can be even though it doesn't matter so our IT dept will be reprograming it to where it will no longer be a required field... Thank you all for responding.. I really appreciate it....
 
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