Author Topic: separating collections for a physician in group practice  (Read 749 times)

bambam2011

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separating collections for a physician in group practice
« on: April 17, 2015, 12:02:32 PM »
I am helping someone set up a new practice and figure out how to separate collection for a particular physician in the group practice. For example, ABC Medical Associates, PA (tax ID: 1234567) has three physicians: A, B and C that provide primary care services then their billing company bills medicare/medicaid and third party payors.  If we need to separate all collections attributable to services rendered by physician C, is there a way to have the medicare/medicaid and third party payors send the electronic payments to a separate bank account? The separate bank account will be opened under the ABC Medical Associates PA's tax ID 1234567.

If the answer is no, is there another way to track the collections attributable to physician C? Can the billing company run a report that would show separate billing for physician C?

Appreciate your input.

RichardP

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Re: separating collections for a physician in group practice
« Reply #1 on: April 17, 2015, 12:34:04 PM »
Medicare has a special definition for "Group".  All expenses must be pooled and apportioned to each member according to a formula set out in writing.  Salaries for each member must be established according to well-defined criteria and that criteria must be set out in writing.  No member may have his salary or other reimbursement based in any way on the income he brings to the practice.

So - if you are working for a group whose definition is acknowledged by Medicare to be a "group", then all payments must go to the billing entity (who gets paid), which would be the Group Name, its Employer ID #, and its Type 2 NPI Number.

If this does not apply to you, if you work for a collection of doctors, but not a group as defined by Medicare, get back to us.

Group Practice is defined here - bottom of Page 38
http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/ge101c05.pdf

General discussion about the issue:
http://www.medicalbillinglive.com/members/index.php?topic=7251.0