Medical Billing Forum

Billing => Billing => : pazamba November 21, 2016, 08:17:01 PM

: Rendering Provider
: pazamba November 21, 2016, 08:17:01 PM

If we bill Medicare for non-participating rendering provider and participating billing provider, what will be the payment:
- full payment as for participating provider or
- 5% less as for non-participating provider?

Thanks a lot,
Alex

: Re: Rendering Provider
: Michele November 22, 2016, 10:48:12 AM

I believe it goes by the billing provider however the rendering provider must be connected to the group (CMS 855R).  When they re-assign their benefits to the group they are considered participating when billing is done under the group EIN/NPI.

: Re: Rendering Provider
: pazamba November 22, 2016, 01:18:39 PM

Thanks a lot Michele!