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Can a billing company that represents clinics, hospitals & doctors get a NPI?

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PMRNC:
Steve, actually that's pretty impressive you had a client that went through due dilligence. I cringe every time I see a biller in those states charging a percentage and their only reason is "everyone else is doing it" Even though the biller isn't doing anything illegal, their providers are. And a lot of states have it on record you can't bill a percentage to Medicaid but you would be surprised (or probably not) how many don't know this or ignore it simply because everyone else is doing it.

Michele:
Not to get picky, but the CMS 855B also has a section for reporting the billing agent so if you are picking up a group with a group PTAN (not a sole owner - because that can be done on the 855I) you would do section 8 on the 855B.

As far as EDI, most states do require the billing service to complete paperwork to be assigned a submitter ID to bill claims electronically, but they can submit on paper (if they want to) without it.

Michele

PMRNC:
You can get your submitter ID before even getting clients and then link it later.

Pay_My_Claims:
OK, that information I do know about, however what Steve had to do....not required in NC :-)

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