pcp/pain mgmt billing

[spinalhealth]

HEEEEELLLLLLPPPPP ?? !!!!!

i have a multispecialty clinic where we have chiropractors, nurse practitioners, massage and physical therapists.  i am having difficulties in getting my nurse practitioner claims paid.  they see patients as pcp's and for pain treatment.

do we need to bill any type of modifier on their charges and if so, which one?  all of my claims are being rejected for missing information......from what i've gathered i need to have the rendering FNP's information in box 24J, 32A and 33A....is that correct?   do i need to have anything in box 32b or 33b?

also, our patients are sometimes referred "in-house" from one of our chiropractors to one of the FNP's for pain mgmt or pcp.....do we need to ALWAYS have a referring provider listed in box 17, 17a/b ??

i would appreciate ANY and ALL help i can get on this - because we're at a loss here trying to figure out what's going on with our claims....

thanks in advance !
jennifer

[Michele]

Boxes 32b & 33b are usually blank unless the carrier has a specific requirement.  Box 17 will depend on if the insurance carrier requires a referral for that type of service for that particular plan.  The rendering provider's individual NPI goes in 24J, the billing NPI goes in 32a & 33a.  If they are denied for missing information you need to find out exactly what is missing.  If you can't tell from the eob, try calling the insurance carrier.  They should help.