NPI Numbers > NPI Numbers
Group or Individual NPI
Michele:
Are the rejections from Medicare? You need to call Medicare and verify the Group PTAN, NPI & EIN number to make sure their files match what you are billing.
Michele
tsbrown:
Hi everyone.
I just received my Licensed Professional Counselor (LPC), Licensed Professional Christian Therapist (LPCT), and Certified Anger Management Specialist (CAMS) back to back. I have a non-profit organization (working with homeless and working poor) which I've had since 1992. I want a private practice and don't know if I should put it under my non-profit or make it profit. The question is I don't know anything about medical billing and want to apply to become a provider for insurance companies. I don't know if I should do it as a group or individual but I'm leaning toward putting the counseling center as a program under my nonprofit. I don't have enough money to pay someone to bill for me yet, but does anyone have any suggestions about anything I've said.
Michele:
Congratulations!
As far as your questions, you need to decide if you want to bill under your ss#, or an EIN number for your private patients. Also, are you going to have other counselors work for you in your private practice? Many people form a corporation even if they are an individual for liability purposes. I can't really advise you on whether to make it a program under your non profit company.
Once you decide on these things you will need to contact the insurance carriers and ask them what you need to do to get on their network. They will help you begin the credentialing process.
Good luck!
Michele
PMRNC:
Have to ask... WHY? Many states have limitations on LPC's and many carriers also won't credential them. You are doing a great service I'm sure but do you want to have to completely change your thinking.. you won't be able to have the kind heart to discount patients anymore, non-profit and medical practice don't really go hand in hand, you'll have to completely change your way of practice :( sounds harsh but Realistic! Why not go to a private practice and be cash only provider, or maybe look into concierge care, so many options.. I wouldn't leap into the world of insurance without really looking at all the ramifications. JMO Give a discount or free care now and you are a wonderful person, give one later when you are in private practice accepting insurance companies and you could find yourself sanctioned or worse.
tsbrown:
Thanks so much. I'm not sure I understand your excellent answer because it was jam packed with mysteries for a newbie. HELP! I never even charged before during the 18 years of non-profit, but I have met my educational goals and need to bring money in now that I am licensed. Please tell me what you mean by state limitations? Carriers won't credential? I will have to change my way of thinking completely? So would you suggest LLC based on your experience (just asking your opinion)? What's concierge care???? Ramifications from using insurance? Sounds like insurance for my profession isn't the greatest idea although I know a lot of centers use it. I don't understand the pros and cons (that's a lot for this site I'm sorry can you suggest how I can research this). Why would insurance sanction me for doing probono, it's encouraged in our profession by licensing board? I'm sure when I have these answers I will understand why you're suggesting cash only. Thanks so much. Sorry I'm so ignorant right now. Time heals all.
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