Wiki ASC Performing Provider

[Rhonda Hammond]

Hello,

For ASC's there should be a performing provider listed on the claim in order to get payment correct? If you have any guidance around this please let me know.

 

[thomas7331]

Hello,

For ASC's there should be a performing provider listed on the claim in order to get payment correct? If you have any guidance around this please let me know.

When you say 'performing provider', I'm assuming you mean the name of the physician who performed the surgery? There isn't really a 'performing provider' on a facility claim since the ASC is not billing for the surgery itself, but only for the use for facility.

It's possible that some payers may require this information on the claim in order for it to be reimbursed. If the ASC is billing on a UB-04 form, there's a space for the credentials of the attending and/or operating provider in boxes 76 and 77. If billing on a CMS-1500 form, you'd probably put this information in the 'referring provider' field in box 17 if the payer requires it.