Author Topic: facilty vs physician  (Read 1716 times)

wmpacoder

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facilty vs physician
« on: April 24, 2009, 09:59:20 AM »
I'm trying to understand a situation, wondered if you could help.  I work on the physician side therefore I am not familiar with facility billing.  If a specialtiy physician practice is located in a hospital and the providers are hospital employees.  Are all services provided billed on UB04 or are some billed on 1500?  I think it depends on how the insurance company credentials the practice "facilty or physician".
 Also... a practice not "in" the hospital (on the same grounds) will become "hospital" employees... will thier services be billed facilty once they become "hospital" employees?   Right now they bill physician side, will that change?  I appreciate any info you can provide.
Thank you,

Michele

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Re: facilty vs physician
« Reply #1 on: April 24, 2009, 12:22:00 PM »
I personally have not worked in a hospital but usually they will have both facility billing which is done on the UB04's and professional billing which is done on CMS 1500's.  When the physician sees the patient it is considered professional billing, whether in the hospital or in an office.

Michele
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