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another PT treating a patient

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Anne:
If a PT wants to pay another PT to treat a patient for her, how do you indicate that on the claim.  I believe for Medicaid patients you put U1 in as a modifier, what about the primary?  Do you also use U1 for them?  Who's NPI and tax ID do I use?  The first PT has a group NPI and Tax ID.  What is she's an individual provider?

Michele:
If a PT wants to pay another PT to treat a patient, but still wants the insurance reimbursement to go to him/her, then the PT that would be treating the patient would need to be credentialed by the insurance carriers under the first PT.  Then on the claim, the name of the treating PT would go in box 31, & that PT's individual NPI would go in 24J.  The first PT, who wants to be reimbursed, would put their billing info and Group NPI in boxes 32 & 33.

Thanks
Michele

Anne:
What if first PT is out of network? 

Alice Scott:
If the first PT is out of network, the PT that is paid to cover (if covered under the first PT) would also be considered out of network.
Michele

Anne:
what if the first PT - the one to be reimbursed just has an individual ID, not a group ID, can we do the same thing?  thanks, Ryanne

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