Author Topic: Covering Provider  (Read 2756 times)

Billing2

  • Jr. Member
  • **
  • Posts: 59
Covering Provider
« on: November 12, 2013, 10:15:03 AM »
It's been many years since I billed for a covering provider.

It's for a Chiropractic office, I know he has to do all the chart notes and we have his name on the paper work. But the covering provider is trying to tell me he can't code it. He'll write down what he does and when the provider gets back she can code it. I do not want to bill it out if that happens.

I feel that is very wrong. Please HELP.

Also what about the insurances companies? Donít they need to know he is doing the work?

Before you all ask, no he is not hired though a covering agency. Itís a friend of theirs, who is a License Chiropractor.



DMK

  • Hero Member
  • *****
  • Posts: 680
Re: Covering Provider
« Reply #1 on: November 12, 2013, 11:16:30 AM »
I'm not understanding why he "can't code it".  He's providing the service so he should know what the procedure code is, and he's making a diagnosis in order to provide the correct service so he should know what the diagnosis code is.  The rendering provider is totally responsible for the services they rendered.  If they got sued, they'd be on the hook, not the doctor who's on vacation.

The rendering doctor's NPI should be on the claim form, but the payment can go to the clinic where services are performed since he is a locum.  HOWEVER, I'm not 100% positive about locum billing because that would mean that the locum would have to be approved by all insurances, and then there's the Medicare sticky wicket.  Hopefully someone far smarter than me will chime in on locum billing.

PMRNC

  • Hero Member
  • *****
  • Posts: 4217
    • One Stop Resources & Networking for Medical Billers
Re: Covering Provider
« Reply #2 on: November 12, 2013, 11:24:37 AM »
Quote
It's for a Chiropractic office, I know he has to do all the chart notes and we have his name on the paper work. But the covering provider is trying to tell me he can't code it. He'll write down what he does and when the provider gets back she can code it. I do not want to bill it out if that happens.

The situation of locum or not is moot. IF it's not the responsibility of the billing company to provide coding that is that. ULTIMATELY the provider is responsible, they have 2 choices. Get a coder or code themselves. Refer to your contract if you need to. again the situation (locum or not plays no part in the contracted services you are hired/contracted to do).  If a client sends me something not coded, it goes back, I document I sent it back and it does not get billed until they code it.

Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Billing2

  • Jr. Member
  • **
  • Posts: 59
Re: Covering Provider
« Reply #3 on: November 12, 2013, 01:16:41 PM »
I never code. I make all my providers code. It's more he is going to wait and have the provider on vacation code when she gets back.




DMK

  • Hero Member
  • *****
  • Posts: 680
Re: Covering Provider
« Reply #4 on: November 12, 2013, 01:23:02 PM »
The point is, the doctor on vacation didn't see the patient and didn't provide the service, why would/should she code?

Billing2

  • Jr. Member
  • **
  • Posts: 59
Re: Covering Provider
« Reply #5 on: November 12, 2013, 02:52:34 PM »
The point is, the doctor on vacation didn't see the patient and didn't provide the service, why would/should she code?
[/quote

That is my point exactly. I told the office he needs to code each visit. If he does not I will not bill it out.




RichardP

  • Hero Member
  • *****
  • Posts: 688
Re: Covering Provider
« Reply #6 on: November 12, 2013, 03:42:48 PM »
The point is, the doctor on vacation didn't see the patient and didn't provide the service, why would/should she code?

A doctor can pay a coder to read their notes and come up with the appropriate codes.  And we all know that the notes in the chart must support the codes submitted for payment.  Why, then, is it a big deal if the covering doctor leaves notes for the covered doctor, and the covered doctor codes the visit(s) when they get back from vacation?  A bit unusual perhaps.  But certainly no different than what happens when a doctor payes a coder to turn his notes into code.

PMRNC

  • Hero Member
  • *****
  • Posts: 4217
    • One Stop Resources & Networking for Medical Billers
Re: Covering Provider
« Reply #7 on: November 12, 2013, 04:25:04 PM »


Quote
A doctor can pay a coder to read their notes and come up with the appropriate codes.  And we all know that the notes in the chart must support the codes submitted for payment.  Why, then, is it a big deal if the covering doctor leaves notes for the covered doctor, and the covered doctor codes the visit(s) when they get back from vacation?  A bit unusual perhaps.  But certainly no different than what happens when a doctor payes a coder to turn his notes into code.

STILL would be moot with PROPER contract in place. I wouldn't code. it's not a contracted service.  The situation of the attending/loucum is MOOT.. My contract with MY client spells out my obligations.   I don't code. Situation is MOOT.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

RichardP

  • Hero Member
  • *****
  • Posts: 688
Re: Covering Provider
« Reply #8 on: November 12, 2013, 06:52:27 PM »
I wouldn't code. ... My contract with MY client spells out my obligations.   I don't code. Situation is MOOT.

I don't understand your response.  I was responding to the comment that it was a bit odd for the covering doctor to leave the coding for the covered doctor to do.

PMRNC

  • Hero Member
  • *****
  • Posts: 4217
    • One Stop Resources & Networking for Medical Billers
Re: Covering Provider
« Reply #9 on: November 12, 2013, 08:24:04 PM »
My comment wasn't meant for you Richard, sorry.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

RichardP

  • Hero Member
  • *****
  • Posts: 688
Re: Covering Provider
« Reply #10 on: November 12, 2013, 09:54:26 PM »
Thanks.