Billing > Billing

Billing under a different NPI

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mrsmeck:
We have a doctor that is not in network with a specific carrier, but our other doctors are.  Can we bill out with another doctors NPI that is within the same group and will be paid to the same group npi?

I feel the answer is no, but before I draw a hardline on this with the management I was to have all my ducks in a row...

Thanks!

Michele:
You can't use a different drs npi for that dr because he is out of network.  The rendering dr's npi must be the one on the claim.

rdmoore2003:
not under this

billingandscanning:
Michele is correct. If the insurance company came in and did an audit, the medical record and the claim need to match, example the doctor who saw the patient is the same doctor that billed for the service.

DMK:
What if there are two doctors sharing the front door, one doctor is out sick and the other doctor sees the sick doctors patient?  Or a Locum comes in for vacation coverage?

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