Author Topic: Medicare Part B Credential  (Read 2026 times)

JVentura1

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Medicare Part B Credential
« on: March 31, 2015, 06:44:32 PM »
Hi Everyone,

I am in the process of Credentialing a new site, two insurance providers required a new NPI which I did apply for.  My question is does Medicare Part B Credential for a Clinic - Urgent Care as primary and secondary would be multi specialty.   I am on the fence, bill with one NPI or apply for a new one and bill under two different NPI's

Tough question.



Michele

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Re: Medicare Part B Credential
« Reply #1 on: March 31, 2015, 08:16:40 PM »
Will you be using the EIN/Tax ID from an existing site?  If so you can only have one NPI per EIN/Tax ID#.  That may be your deciding factor.

As for Medicare, I'm not quite sure I understand your question.  Are you asking if you can credential with Medicare as both a clinic and an urgent care? 
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JVentura1

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Re: Medicare Part B Credential
« Reply #2 on: April 01, 2015, 06:56:45 AM »
Thank you for your response.  Yes, I will be using the existing EIN/TIN for the new site.  I would like to credential Medicare Part B as an Clinic - Urgent Care Site and only bill with one NPI.  On NPPES the options for the NPI (Taxonomy) are Clinic - Urgent Care which is considered one.


The other option would be to have another new NPI as Multi Specialty, Internal Medicine listed as the Taxonomy when I apply on NPPES and do the Medicare Part B Credential under the existing EIN/TIN.

Michele

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Re: Medicare Part B Credential
« Reply #3 on: April 01, 2015, 07:16:09 AM »
You may just need to go in to the NPI you already have and make it a multi specialty group and add any appropriate taxonomy codes for the new location. 
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JVentura1

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Re: Medicare Part B Credential
« Reply #4 on: April 01, 2015, 08:00:25 AM »
Thank you for your assistance, I will be starting the Medicare Enrollment Application today.