Medical Billing Forum
Billing => Billing => : FHA March 14, 2018, 01:21:17 AM
-
When a provider is credentialed with 2 different licenses, how do we bill in way to signify (somewhere on the HCFA I assume?) that we are billing under a specific license? This is an issue because for a particular service, the reimbursement is different under one license than the other. We would like to change it so the billing defaults to the license that receives higher reimbursement.
Thank you for your time.
-
I believe this is something you need to make sure is on file with the insurance carriers. On the CMS form you can indicate the credentials by the providers name for the license you are billing for, but the insurance carriers have the providers loaded into their systems under the NPI/Tax ID so I don't know if that will make a difference.
-
Thank you, that makes sense. Was hoping not to have to contact insurance carriers esp since BCBS of IL and HMA Regence are almost impossible to get ahold of but looks like I have no choice. Thanks again!
-
I'd be careful with this. You want to make sure your files match the insurance companies file to which you are credentialed. If you have a contract with them for one license but not another, it's going to cause some red flags. You need to make sure your contract with the carrier covers all licenses.
-
Do you have it under same address or different address?