Wiki OB Hospitalist Billing Question

[cnieto2000]

We have group of eight providers, who have an agreement with a laborist group at the hospital. We pay the laborist group a fixed amount to deliver our babies if one of our eight physicians cannot make the delivery. Due to the agreement, are we allowed to bill the global OB care under our doctor of record?

Thank you,

 

[csperoni]

Yes. This is one of the variety of agreements that providers may have regarding delivery. Some pay a certain fee, some no fee but reciprocal. Some specify each provider/group split bills for the services provided, some specify the primary ob will bill global. As long as the agreement itself has been properly reviewed for compliance, there should be no issue.

 

[tbird]

Yes. This is one of the variety of agreements that providers may have regarding delivery. Some pay a certain fee, some no fee but reciprocal. Some specify each provider/group split bills for the services provided, some specify the primary ob will bill global. As long as the agreement itself has been properly reviewed for compliance, there should be no issue.

I have just run across this issue. For a private practice docs doing only A&P and hospital laborists doing the deliveries, the group can bill global and pay the hospital for deliveries without credentialing each laborist to their group?? All this under a contractual arrangement? Do you need to show a purchased service on a claim?

 

[nielynco]

I have just run across this issue. For a private practice docs doing only A&P and hospital laborists doing the deliveries, the group can bill global and pay the hospital for deliveries without credentialing each laborist to their group?? All this under a contractual arrangement? Do you need to show a purchased service on a claim?

Credentialing is a whole other issue. Many payers will not recognize non-credentialed providers for their plans even if there is an agreement. If you are running up against this I strongly suggest you pass this by a health care lawyer.