Author Topic: Billing for Addictionologist  (Read 1074 times)

BethAnn

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Billing for Addictionologist
« on: July 13, 2016, 01:32:12 PM »
I currently am billing for rehab facilities doing substance abuse and behavioral health. I got a call today from an Addictionologist asking if I could bill for him. He has called other billing companies that specialize in substance abuse and behavioral health but they have all turned him away. I guess what I am trying to ask is does anybody know what the difference would be between these 2 fields? Any help would be greatly appreciated! Thanks in advance!

Michele

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Re: Billing for Addictionologist
« Reply #1 on: July 13, 2016, 01:47:59 PM »
This is not a term I have heard before and we do bill for addiction medicine.  It seems to be a UK term.  Maybe the provider is from the UK and is now practicing here?  In any case I would ask what their credentials are and what services they generally bill.  It may simply be an MD or DO who specializes in addiction medicine. 
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BethAnn

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Re: Billing for Addictionologist
« Reply #2 on: July 13, 2016, 02:11:16 PM »
You were right he is a DO specializing in addiction medicine. I had never heard of addictionologist until today either but that's what he called himself so I went with it haha

How different is addiction medicine to substance abuse and behavioral health? I am assuming it would be done on the CMS1500 form but is there anything else that I would need to know?


Michele

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Re: Billing for Addictionologist
« Reply #3 on: July 13, 2016, 07:19:36 PM »
Yes it is billed on CMS1500 forms.  I'm also assuming he may be doing Suboxone?  If that's the case the billing is actually medical, not behavioral health.  You will be billing E&M codes mostly.  Strange that billing companies would turn him down!  He's just a physician. 
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PMRNC

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Re: Billing for Addictionologist
« Reply #4 on: July 13, 2016, 08:59:45 PM »
Quote
Yes it is billed on CMS1500 forms.  I'm also assuming he may be doing Suboxone?  If that's the case the billing is actually medical, not behavioral health.  You will be billing E&M codes mostly.  Strange that billing companies would turn him down!  He's just a physician.

It's not strange at all..A D.O. Specializing in treating addiction is going to be a mental health practitioner.. it's their treatment that may come under fire. I had to turn an MD away because he too proclaimed to be an addictionologist.. and the services he was billing were NOT going to get him reimbursed, he wanted to provide services outside the scope of his license and many of the carriers did NOT want to contract with this type of provider. Many of the carriers will claim.. your either a psychiatrist or you are not.
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Michele

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Re: Billing for Addictionologist
« Reply #5 on: July 14, 2016, 08:45:27 AM »
We bill for three doctors that specialize in addiction medicine, 2 DOs and an MD.  All three get paid for all of their services and all are processed as medical.  They are not providing counseling, they are providing medical services for the addiction.  They refer them out for the counseling.  All three are great accounts for us.  I would not turn them away without questioning what services they are performing.  When providers prescribe suboxone there are very specific medical guidelines that must be followed.  They are paid well for these services.
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BethAnn

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Re: Billing for Addictionologist
« Reply #6 on: July 14, 2016, 03:14:58 PM »
Thank you for your help! I have found the E/M codes online that I would need. I have only ever billed on a UB-04 form but have read the CMS1500 is easier than that so hopefully this works out!