Medical Billing Forum

General Category => General Questions => : desheba April 24, 2013, 12:40:01 PM

: Renting space??
: desheba April 24, 2013, 12:40:01 PM
If a provider is renting or leasing space in a clinic, can he legally bill as a solo provider and not use any of the clinic info? Would the clinic be used as place of service only?

Open to all comments!

Thanks
: Re: Renting space??
: RichardP April 24, 2013, 07:12:14 PM
... can he legally bill as a solo provider ...

Short answer - yes, if he is practicing medicine as a solo provider at that location.  See my note below.

However, this is probably an area where both your solo provider, and the person he is renting space from should consult a health-care attorney.  Because of the laws against self-dealing that exist at both the State and Federal levels, there may be some legal hoops the landlord and renter need to jump through to ensure that the rental relationship is legal - particularly if the rental agreement will allow the solo practitioner to use any of the clinic's equipment.  A health-care attorney for your state would know if there are any such legal hoops your guys need to jump through.

NOTE:  There are various forms of legal entity's - solo provider being one of them (Partnership; LLC; Corporation being some others).  NPI and PTAN Numbers are provided for these various forms, and a doctor can practice medicine under more than one legal entity type (e.g. practice as a member of a group, and also as a solo practitioner).  The provider must bill as whatever legal entity he is practicing medicine under at that time, regardless of who might be renting space from.

Edit:  Yes, the clinic address could be presented as his place of service.  Your solo provider would need to register the rental address as his place of service with all insurance carriers he participates with, to include Medicare if he sees Medicare patients.  To avoid potential confusion, your solo provider should use a Room Number or Suite Number in his place of service address that is different from the one used by the landlord.  You end up with two medical entities, with one street address, but different Suite or Room numbers.