Wiki Who gets the charge?!

[nics1011]

To all of you intelligent billers:

I work in a multi physician practice and there is a certain question that keeps coming up....

If one physician sees a patient in the hospital on a Friday (for example) and a partner sees them on Saturday since they are on call, but the original doctor does surgery on Monday.....Who gets the Saturday charge ? The original physician from the group who saw them or the partner who was on call and saw them on that day?

I hope I made the question clear enough...

Thanks in advance for any help with this one!

 

[mahoneyemail@aol.com]

I found this and leads me to believe that the rendering provider gets the charge:

The rendering provider NPI is the individual NPI of the provider who performed the services on the patient being billed. The billing provider NPI is the NPI of the person or entity that should be paid for the services. In some cases the rendering provider NPI and billing provider NPI is the same. In some cases, a rendering provider may have multiple billing provider NPI’s. They may have a private practice which has it’s own NPI and they may work for another group or clinic that has a different billing NPI. As long as the insurance carriers have the provider set up correctly on their files, it doesn’t matter.

It is old though.

https://solutionsmedicalbilling.wor...ing-for-an-individual-provider-under-a-group/

 

[CodingKing]

Whoever saw the patent gets the charge.

 

[Texascoder64]

I wanted to add that once the Surgery is done and it puts the patient is a post op global status, then if all of your providers are under the same tax id, they can not bill any f/u visits UNLESS the e/m is for a new/unrelated problem.