Author Topic: Can one physician NPI be associate with two group NPI's  (Read 1235 times)

Barb

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Can one physician NPI be associate with two group NPI's
« on: August 16, 2016, 11:42:26 AM »
My husband bills as a provider for a group practice.  (So and individual NPI and a group NPI).  We have a partnership and would like to bill some other physician services independently of the group.  He is the only partner that is a physician and billing.   Does he just bill under his personal NPI or does the partnership need to get a NPI.  Obviously we want the funds billed thru the group to go to the group and the other to come to us.

Michele

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Re: Can one physician NPI be associate with two group NPI's
« Reply #1 on: August 16, 2016, 04:33:29 PM »
Is the partnership the group?  Or is it a group and a separate partnership?

I'm going to answer based on what I think you are asking.

Your husband works for a group and billing is done under the group NPI & EIN, and payments go to the group.  In addition to that your husband does some private work and wants to bill for that separately with payments going directly to him.  Yes it can be done but you need to contact each insurance carrier to have him set up under his SSN (or tax ID if he has one for himself) & individual NPI as well as attached to the group.  For Medicare he would have to do the EFT form for his individual information as well to deposit the money into a bank account in his name.

I hope that answers your question.  :)
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Barb

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Re: Can one physician NPI be associate with two group NPI's
« Reply #2 on: August 16, 2016, 05:59:46 PM »
He actually is in an incorporated group and this would be a partnership(LLC) (suggested by CPA) where he would be the only billing partner.  Does that change your reply.

Michele

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Re: Can one physician NPI be associate with two group NPI's
« Reply #3 on: August 17, 2016, 07:48:11 AM »
Just a little.  Basically instead of being linked to a group and billing individually he will be linked to two separate groups.  So the new partnership LLC would have to be set up with all insurances under the group NPI and EIN and then he would need to link to the new partnership.  Then when he sees patients for that partnership it will be billed under that group NPI & EIN (with him as the rendering) and when he sees patients in the group it will be billed under their information.
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SybridMD

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Re: Can one physician NPI be associate with two group NPI's
« Reply #4 on: December 09, 2016, 03:18:17 PM »
Yes, physician individual NPI can be linked with multiple groups.

Thanks,
Sybrid MD - Empowering Medical Practices