Wiki Reciprocal billing


Whittier, NC
Best answers
If a physician is employed by the hospital but covers a physician in private practice, would this be considered reciprocal billing?

The guidelines state the covering physician must be in practice for themself or part of another group practice. It does not mention physicians working in a hospital covering private practices.
It depends on how the billing is done. Reciprocal billing is where the doctor who did not treat the patient but "owns" the patient, bills for the services provided by the covering doctor. The concept is that the two doctors cover for each other about equally, so if they each bill for their own patients, even if they did not provide the service during the coverage period, it will even out in the end.
The Medicare guidelines are pretty "fuzzy" regarding the arrangements. Does it get tricky with global ob billing (for example)?