Medical Billing Forum

Billing => Billing => Topic started by: mindy167 on March 16, 2016, 10:52:13 AM

Title: Reassignment of Benfits - Care Coordination Service
Post by: mindy167 on March 16, 2016, 10:52:13 AM
What is the structure for this scenario for Medicare recipients:

PCP contracts with a care coordination organization to perform care coordination services for their patients between PCP and specialists.

1. Reassignment of benefits -- would this be at the facility to provider level or provider to provider level? or both? Are there additional forms required other than the 855R?

2. How is it determined when the services are billed at the individual provider level vs. group level? 

Thanks in advance for the guidance.
Title: Re: Reassignment of Benfits - Care Coordination Service
Post by: Michele on March 21, 2016, 12:28:53 PM
I'm sorry but I don't fully understand what you are asking.  You are stating that the PCP contracts with a care coordination organization.  So are you asking if the PCP would do a reassignment of benefits to that organization?  I'm not familiar with care coordination organizations but I really don't understand what you are asking.