Wiki New provider billing/credentialing questions

Create Wiki
S

sylviah

Contributor
Messages
12
Location
Manteca, CA
Best answers
0
Our practice will be taking on a new provider. They are telling me he will be our employee and will not be billing under his own NPI, his office services will be billed under our Billing NPI. This is how the NP and PA‘s services are billed in our office. But is this allowed with an MD? Also, he will be performing out patient services at a surgery center. And we will also be renting a suite/room/space at a different providers office for procedures there. He also works with different providers in other office locations not related to us. I am not sure what is needed to bill correctly for this provider. He will be closing his own practice at the end of this month. Is he to reassign benefits to our practice? But would this give his other offices any payment issues? What about the suite we are renting? is it as simple as just adding as a practice location with its current NPI? This was dropped on me last minute. I am not even sure I am asking the right questions as I am not very familiar with credentialing. Any help is greatly appreciated.
 
sylviah said:
Our practice will be taking on a new provider. They are telling me he will be our employee and will not be billing under his own NPI, his office services will be billed under our Billing NPI. This is how the NP and PA‘s services are billed in our office. But is this allowed with an MD? Also, he will be performing out patient services at a surgery center. And we will also be renting a suite/room/space at a different providers office for procedures there. He also works with different providers in other office locations not related to us. I am not sure what is needed to bill correctly for this provider. He will be closing his own practice at the end of this month. Is he to reassign benefits to our practice? But would this give his other offices any payment issues? What about the suite we are renting? is it as simple as just adding as a practice location with its current NPI? This was dropped on me last minute. I am not even sure I am asking the right questions as I am not very familiar with credentialing. Any help is greatly appreciated.
Click to expand...
Sylvia, there are alot of questions and concerns in here. I think it might be more easily answered with a phone call. If you are comfortable, feel free to call me at 847-873-9231.
 
I agree there are a lot of concerns. I would consider the primary concern that you cannot bill one physician under another physician. You will need to credential your new hire. Additionally, if your PA/NPs are not credentialed and no billing is done under them, that means they are ONLY seeing incident-to patients, which can only be established patients with an established plan of care. And some carriers do not recognize incident-to and all PA/NP services must be billed under the PA/NP.
 
You must log in or register to reply here.
Top