Medical Billing Forum

General Category => New! => : MARI1188 October 25, 2011, 07:47:22 PM

: NEW PATIENT
: MARI1188 October 25, 2011, 07:47:22 PM
HI EVERYONE I AM NEW TO THE WEBSITE, AND I HAD A QUESTION ABOUT WHAT MY DOCTOR WOULD LIKE TO  DO IN HER OFFICE. SHE HAS A NPP WORKING AND THE NPP SEES ALMOST ALL NEW PATIENTS FIRST AND CODES AS A NEW PATIENT, THE DR IS STATING THAT ANY INSURANCE THAT THE NP IS Credential WITH TO BILL UNDER HER OWN NPI NUMBER, THAT WHEN THE DR SEES THE PATIENT, SHE CAN BILL UNDER HER NPI AND CODE IT ALSO AS A NEW PATIENT. I WAS WONDERING IF THIS CAN BE DONE. AND THEY ALL BILL THROUGH THE SAME TAX ID. IT BE REALLY HELPFUL IF ANYONE KNOWS THE ANSWER?? THANKS :-\
: Re: NEW PATIENT
: Michele October 26, 2011, 09:43:21 AM
I don't believe that any insurance will honor the second "new patient" visit since it is the same practice, same EIN, NPI, etc.
: Re: NEW PATIENT
: MARI1188 October 27, 2011, 06:28:24 PM
Thats what I thought but before, there was this other biller that was indeed billing that way and they did pay for both claims, and just stating that the NPI where different, So i will try and see what to do.
thanks
: Re: NEW PATIENT
: AMCDAD01 November 20, 2011, 10:34:50 PM
If I could add a word of caution...just because the insurance company paid it doesn't mean that it won't be caught on a prospective audit.  Personally, I wouldn't bill it as a new patient if the NP is treating the patient under the same specialty as the physician under the same tax ID.  Just be careful.  It is better to be safe than sorry. 
: Re: NEW PATIENT
: PMRNC November 21, 2011, 11:55:44 AM
If I could add a word of caution...just because the insurance company paid it doesn't mean that it won't be caught on a prospective audit.  Personally, I wouldn't bill it as a new patient if the NP is treating the patient under the same specialty as the physician under the same tax ID.  Just be careful.  It is better to be safe than sorry.

I agree, in addition, if a carrier did pay it, might be good idea to send in a corrected claim so that there is no audit flag .. since the issue is "known" now to be incorrect, it can be construed as a false claim.