Author Topic: Credentialing with the 855B  (Read 2220 times)

jcbilling

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Credentialing with the 855B
« on: September 15, 2010, 05:46:18 AM »
OK - I have a credentialing question that I'm stumped on...If a group practice sends one of their NP's to a skilled nursing facility to see patients, is it correct that the group needs to list the facility's info and NPI in section 4 of the 855B to report to Medicare that the group rendered health care sevices there?

~ Charity

Michele

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Re: Credentialing with the 855B
« Reply #1 on: September 15, 2010, 05:55:06 AM »
Not the facilities NPI, but their address.  It is still the NP's or group's NPI that goes on the form.

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jcbilling

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Re: Credentialing with the 855B
« Reply #2 on: September 15, 2010, 06:19:57 AM »
Oh - but on the claim form, we would indicate in Box 32 the SNF and their NPI or the group's NPI?

Michele

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Re: Credentialing with the 855B
« Reply #3 on: September 15, 2010, 06:35:11 AM »
On the CMS, it is the NF's NPI in box 32.
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jcbilling

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Re: Credentialing with the 855B
« Reply #4 on: September 15, 2010, 06:36:18 AM »
Along those same lines, when we add that SNF in Section 4, we use the NPI of the group that is sending the NP to see patients. And I would assume the Medicare PTAN of the group sending the NP as well. But if the group doesn't have a PTAN for that jurisdiction yet (the reason the 855B is being completed), then that would be left blank, is that correct? They have a PTAN for another jursidiction, but that would be applicable in the jurisdiction that the group is enrolling with...correct?

Wow - my brain is hurting!!!

jcbilling

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Re: Credentialing with the 855B
« Reply #5 on: September 15, 2010, 06:37:55 AM »
I think I understand - so the NPI on the 855B is to associate the Facility with the group NPI of the NP. But on the claim form, it needs to have the facility's NPI where services were rendered.....am I thinking through that correctly?

Michele

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Re: Credentialing with the 855B
« Reply #6 on: September 15, 2010, 06:59:37 AM »
Yes you are correct, and if you do not have a PTAN assigned yet for that jurisdiciton you can enter 'pending'.

Michele
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jcbilling

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Re: Credentialing with the 855B
« Reply #7 on: September 15, 2010, 08:21:19 AM »
Thanks so much Michele!