Billing > Billing

Chiro billing in MD/DO offices?

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lotus921v:
As a chiro, I am looking at doing some daily contract work in MD offices.  I am not in network with any insurance companies, and am looking to have them bill out using my NPI number and keep the receivables while giving me a flat daily rate.  How on earth does this work?  Is there a way for them to use their in network status and bill out for my services?  Any help would be hugely appreciated as I have never done any of my own billing!

PMRNC:
Not a straight forward answer as it depends on your legal arrangement with the group. I can tell you that you will need to be credentialed with the carriers in order to get paid at the par rate.   Again, there are more things to consider but it all depends on your legal structure within the group.

lotus921v:
I was leaning towards being contracted as an independent contractor.  Can they bill out using their npi numbers?  Or if they use my npi, does that mean they can get paid the out of network rate?  I also am planning on using this similar arrangement at multiple MD offices, so in your experience, is that going to start becoming a problem?  What would you suggest?

PMRNC:
No matter what you will need to have your own NPI and bill with your own NPI and you will also have to be credentialed with any insurance companies in order to service at par rates. That's a given no matter what.  I would suggest talking to your attorney for the business relationship issues, there are a lot of legal factors to consider.

lotus921v:
Sounds good.  I appreciate the advice.  I will def consult with my attorney.  It helps if I have specific questions to ask him so he racks up less of his hourly rate.  Last questions for now.  If i am out of network, the practice is in network, we bill using my npi number, does that mean that we are 1. restricted to patients with out of network benefits? and 2. Get to bill higher out of network rates?   

Side question, i know groups have group npi numbers.  When are those used?

Thanks so much!

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