We are forming a new Med Group practice, structured as a Corporation to provide billing and render services/therapy for patients. we will be leasing space in an existing Cardiology private practice as a separate Corporation.
Our Group will be hiring some of these Cardiologists as W-2 employees because these MDs would like to provide ancillary services such as Physiotherapy. the new group will deal mostly with PPO private insurance, not medicare, as we will be billing services under our group as OUT of Network.
my questions are:
1) what NPI and taxonomy would I use to register this group under if we are using MDs as Cardiologists, yet providing non-cardiovascular ancillary services such as Physiotherapy?
2) although these MDs are Cardiologists, would there be an issue of reimbursments due to their specialty not being the same as say a Physiatrist or Physical Therapist when we send in claims for Physical Medicine/Therapy?
3)our Group practice will NOT be contracted with any insurance as to capture OUT of Network benefits only. If these cardiologists are already IN Network in their own Group practices and possibly as individual providers, HOW would that affect the claims if these MDs are hired under our Group practice as being OUT of Network?
.....Although I know the answer to this for a Physical Therapist, after speaking with BCBS reps, they said it doesnt matter if the PT is in or out of network working at other facilities, they reimburse based on the status of the billing group being IN or OUT of network...so does this apply for the MDs in our case as well?
thanks for any help!