Author Topic: Billing Group NPI#  (Read 1015 times)

Darlene

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Billing Group NPI#
« on: February 22, 2017, 12:56:37 PM »
I am new to billing and have a question regarding billing insurances with a group NPI#.  Is this the correct way to bill for a group of Nurse Practitioners in Iowa or should I be billing the insurances under each individual NP? I appreciate any feedback I can get regarding this.

Thank you, Darlene

RichardP

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Re: Billing Group NPI#
« Reply #1 on: February 23, 2017, 01:17:23 AM »
How do the NPs get paid?  Are they on salary, paid by an organization they work for?  Or are they each paid directly by the insurance carriers?

You mention a group NPI number.  You always bill with the NPI number of the legal entity that is the billing entity that expects to get paid.  In this case it seems to be a legal entity that will then turn around and pay a salary to the NPs.

To clarify, just ask one of your NPs.  If they are on salary, it appears that the organization is the billing entity that expects to get paid by the insurance carriers.

Darlene

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Re: Billing Group NPI#
« Reply #2 on: March 03, 2017, 02:47:21 PM »
I'm sorry it has taken me so long to get back to this conversation. Yes, our NP's get paid a salary by the organization. So, sounds like we are doing that correctly. Can I ask you another question? So, each NP should be credentialed with each insurance company? I really appreciate your help with this!!

Darlene

Michele

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Re: Billing Group NPI#
« Reply #3 on: March 05, 2017, 11:58:39 AM »
Yes they should be credentialed and linked to the group.  Not all insurances credential NPs but most do.

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Darlene

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Re: Billing Group NPI#
« Reply #4 on: March 05, 2017, 12:15:07 PM »
To clarify:

I bill out the encounters under our group NPI# and credential all our Nurse Practitioners to the insurances and put them as part of our group. I will have to fill out forms for Medicare and Medicaid also, correct?

I really appreciate you directing me in the right direction. We are a small private practice and I wear many "hats" and this is a learning process that I want to make sure I set it up correctly.

Thanks for your help!! What a wonderful place to ask questions and get correct answers back!!

Michele

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Re: Billing Group NPI#
« Reply #5 on: March 06, 2017, 07:11:13 AM »
Yes, claims are filed with the group NPI & EIN for the billing provider and the NPs individual NPIs are billed as the rendering provider.  Each insurance carrier needs to be contacted first to find out if they credential NPs.  Some will tell you to bill under the supervising dr, others will credential separately.  Medicare does enroll NPs so yes, you would have to do a Medicare application for the NP and a CMS 855R to reassign their benefits.  Medicaid will vary per state so contact them to find out if they need an application.

Hope that helps!
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Darlene

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Re: Billing Group NPI#
« Reply #6 on: March 06, 2017, 06:02:57 PM »
Thank you for your help with my questions!!

Darlene
 :D