Medical Billing Forum

NPI Numbers => NPI Numbers => : waynem May 03, 2010, 01:53:26 PM

: Single Member LLC Tax ID
: waynem May 03, 2010, 01:53:26 PM
We just learned that for IRS 1099 purposes, we should have been using the LLC's sole owner SSN when sending W-9's.

We have been using the LLC EIN for NPI and Medicare purposes for several years.

What steps do we need to take to get this corrected with minimal disruption?
: Re: Single Member LLC Tax ID
: medauthor May 03, 2010, 07:04:53 PM
Why is this?  My new provider sent W9s' with the LLC's tax id #, not the sole member's soc sec #  ???
: Re: Single Member LLC Tax ID
: PMRNC May 04, 2010, 09:24:47 AM
Yeah I agree with Michelle, You would use the EIN, only reason you would use the SS of the sole owner is if they did something for you as an independent contractor outside of the group.
: Re: Single Member LLC Tax ID
: Michele May 04, 2010, 10:20:20 AM
and I agree with Linda and Michelle.  If they have an LLC and an EIN, why would they want to do the W9 under the SS#?  If they want Medicare to pay under the LLC then they cannot enroll with the ss#.  But in case there is a reason to what you are saying, you would complete a CMS 855I, CMS 588 EFT and a CMS 460.

Michele
: Re: Single Member LLC Tax ID
: waynem May 04, 2010, 11:04:05 AM
Page 2 of the W-9 "Specific Instructions - Name - LLC" says that for a Single Member LLC you need to enter the owner's name in NAME box and the LLC in the Business name

Page 3, "Part 1. TIN" - 3rd paragraph, states the OWNER's SSN/EIN needs to be entered if it is treated as a "disregarded entity" for tax purposes. There is a chart on page 4 (#5)

This was not know by us until recently.
: Re: Single Member LLC Tax ID
: tinapiro June 10, 2010, 09:07:43 PM
I know this is a month old, but I thought maybe I could clarify this a little bit.  My background is accounting so I thought I might be able to shed the light on this a little more.  When filling out a W-9 for a corporation, partnership, or sole proprietorship it's very basic - you have an EIN for a corporation or partnership and you use a SSN for a sole proprietorship.  When an LLC is formed, you still have the option to form under any of these categories.  If they form under a corporation or partnership, you use an EIN.  If the LLC is formed under an individual (sole proprietorship), it's considered a disregarded entity and the individual should use their SSN.  The issue with the LLC and the W-9 is that you may not always know if they are a sole proprietorship or not.  They may not have their individual name listed in the name box, and they don't always mark the tax classification (C, P, or D).  I always make sure they have the tax classification box marked - it's the only way you know for sure whether the company is formed under an individual.

I hope that helped a little bit.   
: Re: Single Member LLC Tax ID
: PMRNC June 11, 2010, 12:04:15 AM
If the LLC is formed under an individual (sole proprietorship), it's considered a disregarded entity and the individual should use their SSN. 

I've been an LLC (sole proprietor) and I've always used my EIN ???
: Re: Single Member LLC Tax ID
: dekenn June 11, 2010, 02:45:13 PM
When we set up my husband's practice, (sole proprietor), we did NOT form an LLC, but were told by our accountant that we needed an EIN for the business so we could pay the employees, and get paid by the insurance companies. We always have filled out the EIN on the W-9's.  Because of past business with Medicare, he was already enrolled in Medicare under his SSN.... which, is now causing complications with the electronic billing and crossovers.  When I called Medicare, they told me to fill out the enrollment forms 855I with his EIN number!! ??  I don't think anybody really knows what the correct way is, as long as it's consistent I guess... (reporting income and paying taxes!!!)   ??? ??? ???
: Re: Single Member LLC Tax ID
: tinapiro June 11, 2010, 03:22:56 PM
Since LLC's are created through state laws (and not federal laws), they aren't recognized by the federal government as a separate tax classification.  The federal government only recognizes whether a company is a corporation, partnership or sole proprietorship.  A single member LLC who is being treated as a disregarded entity (did not fill out the 8832 to be treated as a corporation) and who does not or will not have employees, should report under the single owner's name and SSN.  If (or when) a single member LLC hires employees, they must use the LLC's EIN - you can't report payroll taxes under an individual's SSN.  

As far as your husband's practice, if he has employees he should be reporting everything under the business EIN.

Linda - do you have employees?  If so, your good to go because you should be using your EIN.
: Re: Single Member LLC Tax ID
: dekenn June 11, 2010, 05:12:42 PM
That makes sense..... now the daunting task of getting Medicare switched over to his EIN... should be interesting. Unfortunately, I know the deadline for PECOS is next year, so I keep putting it off..   ::)
: Re: Single Member LLC Tax ID
: PMRNC June 11, 2010, 11:17:46 PM
No, no employee's, but I've been setup this way for 7 years.
: Re: Single Member LLC Tax ID
: medauthor June 13, 2010, 01:22:35 AM
I have to agree with Linda here....I, too, am a single member LLC and used my EIN.
: Re: Single Member LLC Tax ID
: Pay_My_Claims June 13, 2010, 04:21:19 PM
it think its new, because when I applied online, I got the same message as a disregarded entity. a single provider LLC
: Re: Single Member LLC Tax ID
: PMRNC June 15, 2010, 01:42:33 PM
Ok, I happened to ask my accountant yesterday and he said it's correct that the LLC laws vary from state to state.. There are states that have a requirement on how many can form an LLC. The use of the EIN is your choice as long as it's followed through.. I could have used my SS # being that I had no employees but I had already had an EIN so that is what I used and it's perfectly acceptable and legal. Now in the states where you can't have single member (sole proprietorship) LLC's then I imagine it's different. Oh and also he says it goes by the state in which you create the LLC.. You don't have to setup in the state you are in. For example many companies setup up different corp statuses in Delaware  ;D ;D
: Re: Single Member LLC Tax ID
: evans1035 October 01, 2010, 08:52:20 PM
Ok, I think this might be part of the same problem my provider is having with Medicare, and I also don't know what to do about her other carriers.
 Medicare sent something to a 15 year old address (which I thought was changed since current address had been filled out on NPI, NPPES websites), it came back and they sent out a letter to her saying she had to revalidate. Letter dated 4/1/10, she actually got 5/15/10, saying she had 60 days to do what the letter said. So, we filled out the 855I with address correction (after I went through app section by section with a prov enrollment rep, and then another one to clarify more a few days later - of course they said different things - first rep said for the address situation mark "change" by practice location; second rep, said we needed to delete the 15 yr old address, then do a separate page to "add" the so-called new address).

Then we get a letter 8/2/10 saying based on info received, she NOW MUST HAVE an organizational NPI. Apparently, all this time her Medicare PTAN and NPI were individual and linked to her SS#, not her Tax ID, even though that's what I've always put on claims. She is a Professional Corp., but it's just her. That was already in place when I took over billing, so I had no reason to question anything. Ok, so we do everything in the letter and 8/25 we get another letter that they have de-activated her old # back to 3/5/10, even though the original letter was dated 4/1 and said she had 60 days to revalidate, and she was issued a new group PTAN and we had gotten a new grp NPI.OK, I THINK I MIGHT HAVE TO CONTINUE ON ANOTHER MESSAGE SINCE THIS SEEMS TOO LONG.

: Re: Single Member LLC Tax ID
: evans1035 October 01, 2010, 09:10:04 PM
Medicare nightmare (continued)...
Because Medicare backdated the deactivation date of old ptan and npi to 3/5/10, and made new grp ptan and grp npi effective 5/26/10, they are not going to pay her for charges to these patients, technically from 3/5 until 5/26/10 dates of service (although they had already pd 3/10 dates before they sent whatever they sent to the old address). In one of their letters they say something that they have to at least make eff date of new # back 30 days, which would be 4/26. When I asked rep about it, she said oh, that's for revalidation, and this is now considered a new application, so it doesn't apply.
 How do you ever know if the rep you're speaking to has any clue about all of this?
THIS IS DROWNING ME!!! Provider is also worn out from all this, and says just bill under the new #. She wants me to also rebill the charges in that gap also and see if they pay. From what I could figure out from the 42 CFR 524.520 they quoted, that could cause more trouble and I left her a message to that effect.

Sorry this is so long, but I have so much paper from this nightmare, it's hard to explain everything.

My actual question at this point is: What do I do about all the other carriers (BCBS, Medicaid, UHC, Aetna, etc.)? I've always submitted all those on her tax ID and had her address on claims, and 1099s she gets from them show her tax ID #, so do I tell them she now has a grp NPI? What if Medicare and other carriers ask for money back? This was not any attempt to defraud anybody, and as I said, it is just her in her practice. I'll have her Sept billing in the next few days, and I don't know what to do about the NPIs or how to ask carrier about all this without having more issues.
DID I MENTION THIS IS DROWNING ME? I WANT TO QUIT BILLING NOW. THIS IS MAKING ME PHYSICALLY ILL...
: Re: Single Member LLC Tax ID
: DMK October 01, 2010, 10:00:19 PM
I can only offer you what I went through.

You won't have the same run around with other insurance companies.  Just call provider relations as you have time and find our what they want you to fill out.  We ran into the same thing with a group NPI vs. individual NPI.  We were just a sole proprietor so the group NPI we were told to get was wrong.  Long story short, regular insurance companies will have A form and will make the changes easily.

Medicare, on the other hand, was a nightmare for us when we moved our office.  We happened to do this right when they were changing vendors too.  So a one line address change took me 9 months.

Fill out the application form being extremely careful to dot all the i's and cross all the t's.  When you show the doctor's SS#, EIN, PTAN, and NPI they will finally all be joined on one form.  You can then show the old address start and stop dates AND the new address start dates.

Once they have it scanned in their system, you can speak to someone who has it all on their screen.  The hold time on the phone is a killer, so set aside a day and time to devote to it and be patient.  It sucks, but it has to be done. 

Your doctor will have to switch to EFT if they haven't already done so.  Medicare is eliminating checks.  I was scared to do it, but it has worked great so far.

It took a long time for me because I didn't know what I was doing.  I ultimately got it right, and we got paid on everything.  I'm ashamed to admit it, but I cried when the first payment came in.  Seriously.

Best of luck to you, and if you need help finding the right phone numbers I'll gladly help you!

This is a great forum and all the people here are so helpful.  We've ALL been where you are!
: Re: Single Member LLC Tax ID
: Michele October 04, 2010, 10:44:33 AM
The problems that you are describing are the reason that we started doing Medicare credentialing as a service.  Many providers that just move their location, or change from their ss to an EIN, but do not know how to do the paperwork Medicare requires, end up with a huge headache, or losing a lot of $$.  Once you understand exactly how Medicare works and what they require it is not as much of a nightmare.  I don't mean to minimize the situations you went thru because I completely understand.  But having done over a thousand Medicare CMS forms, I know exactly why Medicare requested what they did, and why the provider/biller didn't understand.  Since most providers/billers don't need to complete CMS forms on a regular basis they do not know what needs to be completed and why.  AND lets not forget to mention that Medicare often "updates" the CMS forms, which changes the whole thing up just a little!   ;)
: Re: Single Member LLC Tax ID
: dekenn October 04, 2010, 02:42:50 PM
How long do we wait for Medicare (we are under Highmark Medicare) to assign the application to a reviewer?  I submitted the new application online (we weren't in Pecos, and had to switch from his ssn to ein), got the certified mail confirmation (mailing in the certification statement and EFT form) on August 9.  Finally called last week, the rep confirmed they received it, but it has not been given to a review yet.  At what point can we complain about the delay?  Any one else experiencing these delays???
: Re: Single Member LLC Tax ID
: Michele October 04, 2010, 11:48:23 PM
Per CMS guidelines, they (Highmark) have 120 days to complete the application.  If they require additional information or corrections, the 120 days starts over from the date they receive the corrections.

: Re: Single Member LLC Tax ID
: evans1035 October 12, 2010, 01:22:51 AM
Ok, so from what I could tell from Medicare's IVR system (when I could get a response and it didn't hang up on me), they say all the claims I resubmitted under her new group npi have been approved to pay and the amount, although it is apparently too soon for them to have actually sent the funds to her bank acct.
  Now my next problem is to figure out what needs to be done with the commercial carriers as far as her npi. I believe her indiv NPI is already attached to her tax ID #, since I was seeing both on some of the carrier eobs (like Aetna and United Beh Hlth), but then which npi needs to go in now on claims? Do both NPIs go in and if so, which one goes in which box?  I called United Beh to see where to send a notice of the new NPI and the person I spoke to told me that they will only go back to the beginning of the month they get the notification, so I called my clearinghouse and told them to send the 9/10 claims with the indiv npi on them when I resend them, so now I'm trying to make sure it goes to clearinghouse with correct npis in correct places.
I am going around in circles at this point, I think.
: Re: Single Member LLC Tax ID
: Michele October 12, 2010, 10:05:38 AM
It is really better to have all insurance carriers set up with the same info.  I would go for the individual NPI for the rendering provider (box 24J on the CMS) and the group npi & EIN for the billing provider info.  EIN in box 25, Group NPI in box 32A & 33A.  I would get all carriers set up that way ASAP, otherwise you are looking at a billing nightmare, especially on claims that are crossed over by Medicare.
: Re: Single Member LLC Tax ID
: evans1035 October 12, 2010, 12:08:30 PM
Michele,
Thank you so much for the response. From everything I've been reading, I can see that's how it should be, but I'm still unclear as to if she needs a new indiv npi under her group npi, or can just use the one she's had all this time.
  For Medicare, my clearinghouse person said they sent the new claims in with both her individual NPI and new organizational NPI on them. I just checked the automated system again and they said all those claims are processing, and that approved amt is 64.41 and pd 51.53. I'm hoping the reason no funds have been disbursed yet is that it hasn't been 14 days yet.
  Also, when I checked on the automated system, I put in her group PTAN, not an individual PTAN. My clearinghouse said on the claims Medicare no longer wants to see PTANs anyway, so they were sending in both old indiv and new NPIs, so I'm worrying that since they deactivated her old indiv NPI they won't actually pay in spite of what the automated system said. Thanks for the help. Carol
: Re: Single Member LLC Tax ID
: Michele October 13, 2010, 09:51:48 AM
A provider can only ever get one individual NPI.  That stays with them for ever.  They would never have two individual NPI's.  It sounds like you should be fine from this point.

Michele
: Re: Single Member LLC Tax ID
: evans1035 October 13, 2010, 12:49:37 PM
Thanks for the response Michele. It took a long time to sink into my head that the identifier is just that, and identifier, not a tax id. I've been calling my client's main carriers to see what they will require to add the org npi. Not only does every carrier give different answers, but the people don't seem to clearly know the answer either. I called BCBS of CO yesterday after looking on their website. There is a provider change form there and on there it says "You do not need to do a W-9 if the TIN is not changing." Well, it's not, and all the carriers with exception of Medicare had her TIN tied to her indiv NPI anyway, yet woman @BCBS says we have to fill out a w-9 and send a formal letter to add the org npi. I kept asking for clarification of why the website said one thing and she was telling me another, and she let me speak to the supv who also said we had to do the w-9. How do I straighten things out when the carriers' online info and prov svc reps don't say the same thing?
Carol
: Re: Single Member LLC Tax ID
: PMRNC October 13, 2010, 04:52:13 PM
I hate that too when different carriers want different things. I usually just comply as it's much easier than arguing. I would go ahead and give them the W9.  It might be that the previous TIN didn't match the W-9? They ALL have to match exactly with their Tax information.. right down to crossing the t's and dotting the i's.