Medical Billing Forum
Billing => Billing => : newbie54 June 26, 2016, 12:57:25 PM
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Our doctor is a sole-proprietor and has an individual NPI and EIN. He is hiring a new associate physician who has just finished her residency and also has an individual NPI. Since the new physician is an employee and paid by salary, can I bill using her NPI under "rendering provider" (box 24) and then use the owner's individual NPI for the billing provider (box 33) even though it is an individual NPI or do I have to have him get a group NPI even though he is not incorporated?
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I think I answered my own question by reading under the "NPI" section of this board. Because my provider is a sole proprietor I can use his individual (Type 1) NPI in box 33 and use the rendering physician's NPI in box 24j, but I still have to get the new physician credentialed by the various insurance companies. She has already reassigned Medicare benefits to the owner's NPI. Does anyone know if any of the insurance companies allow held claims of say 90 days so she can start seeing patients but we won't submit the claims until after she is credentialed?
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Each carrier varies. Most make the effective date based on when they receive the application however when adding to an existing NPI that may be different. I would ask when you contact them to see what needs to be done.