NPI Numbers > NPI Numbers

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

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Pay_My_Claims:
No, I meant the enrollment part. We didn't have to do that in NC, but I will recheck. I asked about all the requirements, and thus far I have had no issues.

PMRNC:
Form 855I (or the others if applicable) is required to submit certain changes. One of the changes required to be reported/changed is if the "billing agent" is added/changed  You can view this in the instructions with the Form 855I here:
http://www.cms.hhs.gov/cmsforms/downloads/cms855i.pdf   This is a CMS requirement

When I take on a new medicare client this form is included in my packet along with all the clearinghouse paperwork, contracts, etc. I also have another form which allows me to access their PECOS by creating a login. When PECOS first came about, billing agents could not do this, now they can.

In regards to PECOS providers/authorized agents, can change/enroll through the PECOS system by logging in or creating a log in here: https://pecos.cms.hhs.gov/pecos/login.do   If making a change of the billing agent, this also is an option.

So in a nutshell a change of billing agent or the addition of a billing agent DOES require a change in Medicare Enrollment With CMS.

Pay_My_Claims:
No, I must not be understanding what Steve posted, I'm not talking about the form(855I) that we complete when the provider is now using us as his billing agent. I thought Steve meant he had to "register" as a billing agent in the sense of PRIOR to having a client.

PMRNC:

--- Quote ---Where I live and work, Billing company or Billing agents must register and enroll with Medicare and Medicaid as a billing agent.  A billing agent number will be assigned by Medicare but it never goes on any claim form.
--- End quote ---

He'll have to clarify what he meant, but for All States (CMS) the 855 is where they pull the billing agent.   OR it could a separate registration with the state. NJ requires all third party billing companies to register.. whether they are IN NJ or doing business in NJ or both, regardless of who you are billing (Medicare, etc) that's a state level registration requirement and also does not grant you a number or any other identifier on the claim form.

Steve Verno CMBS, CEMCS:
i had a client.  In order for me to bill my Medicare and Medicaid, I had to enroll as a billing agent.  To send claims electronically I had to send a completed EDI agreement with a copy of my contract so they could see I wasnt charging a percentage of what I collected when I billed.  With Medicaid, I had to go to the local police department, undergo fingerprinting and pay for a Medicaid background check just like the providers I enrolled.  This was a requirement in my state and not neccessarily the same in evey state.  Medicare wouldnt let me send claims until I got my billing agent number.  Neither allowed me to send claims electronically until they approved the EDI agreement and I sent sample claims. The file I sent was inspected and had to pass with X% errors.  if I passed, I got a letter saying I was approved to send real claims.  When the practice hired me, they had to send the 855 form to Medicare showing I was their new billing agent.  Again, this is local to where I am here in Florida.  I didnt have to do this when I was in New York. 

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