Author Topic: How can I bill my own cases?  (Read 1388 times)

Aaron

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How can I bill my own cases?
« on: October 12, 2011, 10:50:00 PM »
I am a surgical assistant working independently for a number of different doctors. They provide me with op notes, codes (diagnostic and procedure), NPI’s. I would like to begin billing my own cases. Any input suggesting what steps I need to take in order to do this? Is there a good book that could help someone in my position? Thanks!

Michele

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Re: How can I bill my own cases?
« Reply #1 on: October 13, 2011, 07:27:21 AM »
So you work independently?  Do your services not get billed out?  Do you have your own NPI and are you set up to bill insurances?  You need to decide (if you haven't already) how you will file with the IRS, under your SS#, or will you form a business of some sort and get an EIN.  If you form a business you may need a type II NPI for the business.  Will you get in network with insurances or just bill out of network?

Lots of decisions......
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Aaron

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Re: How can I bill my own cases?
« Reply #2 on: October 15, 2011, 12:09:34 AM »
Yes, I work independently, and currently have an outside service bill my cases. I compile and send them all codes (sometimes cms1500 from surgeon), face sheets, and op notes. I have my own NPI and file taxes as a business. My case load is much lighter than it used to be because of health issues, therefore I am trying to tighten my belt, so to speak. I assume I will be billing out of network since I am just the surgical assistant. Or do I bill in network if the surgeon on the case was an in network provider?
Thanks so much for your help!

Michele

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Re: How can I bill my own cases?
« Reply #3 on: October 15, 2011, 07:44:30 AM »
It doesn't matter if the surgeon is in or out of network, it depends on how you are set up with the insurance carriers.  It's also not based on how you bill the claim, it's if you contacted the insurance carrier and went thru the necessary steps to get credentialed as in network or not.  If you don't know, it would appear you are out of network.  Being in network requires some paperwork, signing contracts, etc. so you should remember if you had gone thru that process.
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Aaron

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Re: How can I bill my own cases?
« Reply #4 on: October 20, 2011, 10:03:54 PM »
Yes, you are right. I am out of network, have not been credentialed with the insurance companies.