General Category > General Questions

Provider or Vendor

(1/3) > >>

Niosh:
Sorry if this is a basic question but I just can't seem to find an answer anywhere. So my spouse just recently/is in the process of starting her own practice. In order to shift some of the workload from her I thought I could help and do the billing for her. So my question in this respect is do I need to fill out registrations as a provider or as a vendor? I'm currently working my way through the Medicaid EDI and at some points I feel like we can do everything as a provider but then some times I feel like we should be compartmentalizing ourselves as a provider and a vendor. She already has a personal NPI, practice NPI, as well as tax ids and various other long numbers :).
If it sways the answer any, depending on the success of this I might extend my billing services in the area (at which point I'm certain I would have to become a vendor), but in the mean-time can 'we' be the provider?
Thanks in advance for any help, I am sure I will spend a lot of time reading through this forum in the future.

PMRNC:
First, it's not clear what you mean by vendor, I don't know your legal status with your wife's practice.. I would also have to say you might want to consult with an attorney to be sure you are not violating any STARK regulations if you are a part owner/investor of the practice.
If you are going to simply provide the billing, I see no reason why you shouldn't be setup as just an employee?  If you are a billing company you will need to let Medicare know via a change form that you will be the billing agent.


I guess it all depends on your legal setup with your wife, but I would consult with an attorney to be better prepared because the industry has a lot of regulations you will want to be aware of and make sure you are setup properly in compliance.

Also you don't mention your experience with billing or practice management, If you do not have any formal training or education, or experience you might do more harm than good for your wife's practice.

Niosh:
Vendor is the term I see used for various billing service providers or agents, and so that is what I mean by it.
It's a solo practice entirely in her name and we were thinking about setting me up as an employee but can I be an employee that gets paid nothing? I guess I could get paid some amount but it seems that would create a mess for tax purposes.

I wouldn't think it would violate any STARK regulations considering if she were doing it all herself she would have the same financial interests as I would.

I have no formal training in medical billing (does is really show that bad) and my experience is limited to other health care fields (no billing), I'll certainly step aside if I think harm will be done.

Michele:
What type of provider is your wife?

Niosh:

--- Quote from: Michele on January 02, 2011, 09:11:44 PM ---What type of provider is your wife?

--- End quote ---
She is an ARNP specializing in family practice and shortly in psych/mental health once she finishes the clinical hours. This is a new clinic and so the patient load will be fairly small.

Navigation

[0] Message Index

[#] Next page