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yvonneflintdavis

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We have added 2 new physicians to our practice. The new providers work out of 2 different locations, but we bill under the same group tax id and group npi. As part of the new provider training, 2 different practice owners review and sign off on the encounter notes. The practice owners do not follow the patients and are not always at the same location as the new providers. I am second guessing myself regarding who should be the supervising provider on the 1500 form. I have read incident-to criteria and do not believe incident-to critera is met. Do we add the practice owners that are reviewing and signing off on the enounters as the supervising provider on the CMS 1500 form or no? Any clarifiction is appreciated.
Thanks
 
Hi there, I agree these aren't incident-to services. It sounds like you have an internal process for on-boarding new physicians, which is great. However, it shouldn't affect your billing because the services are being billed by the new physicians.

I'm not saying this is happening in your situation, but because it comes up from time to time: When a new physician's enrollment is still pending a practice can't report the new provider's services under another provider's name/NPI. CMS allows practices to submit claims for services that were performed before the enrollment was complete (assuming the enrollment is accepted). I think it is for 30 days after the enrollment is submitted, but I'm not an enrollment pro.
 
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