Author Topic: NPI number with Locum Tenens  (Read 2448 times)

Alice Scott

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NPI number with Locum Tenens
« on: March 01, 2008, 10:51:23 AM »
Question
Hello Alice!  You have helped me previously on 2 questions and I have now run into a problem I can't seem to resolve.  Our doctor was a solo incorporated practice with both an individual NPI and a corporation NPI number.  He only had an individual Legacy PIN (None for the Corporation).  I say was because he died suddenly on October 29th.  We are using a Locum Tenens to cover him as an employee of the Corporation.  I know that usually the Locum Tenens number goes in 24J and must match Box 31 on the HCFA form and that usually the Corporation Name and Address go in Box 33 with the Corporation NPI number in Box 33a.  I have also entered on the HCFA 1500 claim form, that the Locum Tenens is covering our deceased doctor until he can be replaced (I show his name and individual NPI number) in box 19.  My problem comes in when I bill medicare.  According to the NPPES our Doctor is a Entity Type 1 and the Corporation is an Entity Type 2.  Do I bill as Entity Type 1 using the deceased doctor's name and NPI # or because the checks need to go to the Corporation, do I bill as Entity Type 2 using the Corporation Name and Number in Box 33 and 33a.  If I bill as Entity type 2 is it necessary to enter our deceased doctor's NPI or Legacy number in any specific box.  I've verified all the numbers and names on the NPPES database and still I'm getting rejections.  HELP!

Many, many thanks for any assistance you can give in this very confusing matter.
Diane

Answer
Diane,
  Iím sorry to hear about the doctor.   Anyway, you are in a bit of a mess.  You cannot bill under the deceased drís name and individual legacy number for Medicare.  The fact that he didnít have a group Medicare number under the Corporation is a problem now.  I would contact Medicare to make sure, but I think you are going to have to apply for a group Medicare number now, under the corporation, and then reassign the benefits of the locum to the corporation.  You will have to hold billing until you obtain a group Medicare number.

Good luck with this.
Alice

Diane
« Last Edit: March 01, 2008, 06:59:37 PM by Alice Scott »
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