Nurse Practitioners

1formissy

Guru
Messages
193
Location
Salem, Oregon
Best answers
0
Does the NP have their own NPI?

Most payers, including the one I audit for, require the NP and PA to have their own PTAN and NPI if they are billing under themselves. (Follow CMS guidelines.)
 

aprillee

Guest
Messages
5
Best answers
0
NP

I work in a pediatric office and our NP have there own NPI. The problem is when we bill supervising provider as the MD and rendering provider as the NP, private insurance (mainly BCBS) will not pay for a NP. They have told us that we need to bill everything under the MD, even if a NP seen the patient. Is the correct? BCBS said the our HMO patients are not allowed to see a NP.
 

1formissy

Guru
Messages
193
Location
Salem, Oregon
Best answers
0
If you're billing the supervising physician to the NP, than that would fall under Incident-to, and this may be the reason your payer is denying.
Is this a new presenting problem for this patient?
Is the patient a new patient?

If you answer yes to any of those questions, than that claim would deny as not meeting Incident to.
 
Top