Billing > Billing

HELP! BILLING UNCREDENTIALED NP

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bosox85:
Thank you! I have been holding her charges since November 1, so they are really building up. My gut has been telling me for a while now that this is NOT OK. I wish I listened to my gut sooner.

Any suggestions on how to approach this subject with administration?

Michele:
Well maybe they are just unaware that it's not ok.  I would start by saying that you've looked into it and that you found it that it's not ok to bill for one provider services under another provider NPI and you're not comfortable billing them out that way.  See where it goes from there.

bosox85:
Thank you! I really appreciate everything!

kristin:
Just to add...everything you have been told here is dead on...you can't bill for one NP under another NP's NPI as rendering provider. While the NP's who run the office, or whoever runs the office may not have known this, it doesn't change the reality of the situation. Credentialing/contracting of a provider can take a LONG time, and the retroactive date is usually not much, so that provider could have numerous claims that will never get paid.

bosox85:
I am now being told by the CEO of our health care group that because the group's NPI is submitted on the claim and not the rendering NP's NPI number, then we can bill it. I still say I'm not doing this because it is wrong. Who is correct? The CEO or me?

Thanks~M

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