Started a new billing company and now planning to take over a provider

[deedee]

Hello,
I recently started a billing company in the state of MI and I wanted to know when you take on a provider that has been outsourcing with another billing company and the provider decided to switch over to our company. What process should I take? Do I contact all the payors and let them know that our billing company is doing our business? Not sure how to go about doing all of this? What are the process of transition that you would recommend?

Thank you!

[PMRNC]

Hello,
I recently started a billing company in the state of MI and I wanted to know when you take on a provider that has been outsourcing with another billing company and the provider decided to switch over to our company. What process should I take? Do I contact all the payors and let them know that our billing company is doing our business? Not sure how to go about doing all of this? What are the process of transition that you would recommend?

That will depend on what you and the provider have agreed on among other things. Medicare will require a change in the billing agent which is normally done on Medicare Form 855.   You will also need to have the provider enrolled with your clearinghouse. Just some advice, you want to make sure your contract is clear on where you start and has nothing to do with the contractual relationship between the provider and the other billing company.  You should not have any interactions or cross overs with the other billing company.

[deedee]

Thank you for the advise this is really helpful information. Do I need to contact the other insurances like medicaid, BC/BS and other and let them know of the switch?

[PMRNC]

Thank you for the advise this is really helpful information. Do I need to contact the other insurances like medicaid, BC/BS and other and let them know of the switch?

You might want to contact your state Medicaid and see if they require it but normally it's only Medicare unless there will be a change in the provider's file/record.