Author Topic: HELP! Billing for FNP  (Read 1732 times)

tperian

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HELP! Billing for FNP
« on: July 11, 2017, 07:23:42 PM »
I have a question that i feel sure has already been addressed in this forum but here goes... I have a FNP who is billing under the physician.  Here are my two questions:
1.  How should the claim be billed: 
                  Billing Provider:  Doctor
                  Rendering Provider: FNP
                  Supervising Provider:  Doctor
   or should it be:
                  Billing Provider:  Doctor
                  Rendering Provider: Doctor
                  Supervising Provider:  Doctor
2.  Would the RENDERING FNP also need to be credentialed with the insurance?

Please provide as specific an answer as possible because i would like to be able to take this information to the doctor. 

Michele

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Re: HELP! Billing for FNP
« Reply #1 on: July 12, 2017, 11:44:53 AM »
Not all insurances credential FNPs but most do, including Medicare.  If the insurance carrier credentials the FNP then the billing should be done as option 1 below.  If it is an insurance carrier that does not separately credential the FNP then option 2 would be appropriate.

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tperian

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Re: HELP! Billing for FNP
« Reply #2 on: July 17, 2017, 10:32:44 AM »
Thank you for your help.  For the insurance,is it a situation that insurance REQUIRES the FNP be credentialed in order to bill or is it a situation that the FNP has the option of being credentialed.  If she chooses to not be credentialed through the insurance, what are the options?
« Last Edit: July 17, 2017, 10:40:06 AM by tperian »

Michele

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Re: HELP! Billing for FNP
« Reply #3 on: July 17, 2017, 02:51:51 PM »
It is not an option.  For the insurances that credential FNPs the FNP must credential.  Usually insurances that credential FNPs also have a lower reimbursement for services provided by FNPs.  They want the services billed indicating the provider that rendered the services.
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Re: HELP! Billing for FNP
« Reply #3 on: July 17, 2017, 02:51:51 PM »