Billing > Billing

Billing for an "associate?"

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RichardP:
I just ask to see their group paperwork ...

For those who may not know - for CMS purposes, a "group" has a specific definition.  A solo practitioner, or a single doctor who is incorporated, can hire  as many doctors as he has business for and that setup is not considered a "group" by CMS.

PMRNC:
That to me is NOT my concern. I meant that if there is a question I want to see how they are setup. I don't get into the middle of their setup.. I only have purpose to know I'm billing properly.

JAZH:
I am new to this forum. My questions is along the same lines. I work at a 2 physician practice- one is the owner and one is paid a percentage of the work her does. We started using a new practice management software that is linked to our EHR in May. In preparing for the attestations for the EHR incentive it came to my attention that everything has been billed using only the owners NPI number. Apparently our biller was told to do it that way. 1) Can we continue to bill this way if we do not intend to apply for the incentive money for both physicians? 2)If we do need to correct this can we just go back and correct enough claims to qualify for the incentive or are we required to go back further? I would appreciate any input since we are now on a tight timeframe as far as the attestations. Both physicians are eligible and saw enough patients to qualify for the full incentive.

PMRNC:

--- Quote ---I am new to this forum. My questions is along the same lines. I work at a 2 physician practice- one is the owner and one is paid a percentage of the work her does. We started using a new practice management software that is linked to our EHR in May. In preparing for the attestations for the EHR incentive it came to my attention that everything has been billed using only the owners NPI number. Apparently our biller was told to do it that way. 1) Can we continue to bill this way if we do not intend to apply for the incentive money for both physicians? 2)If we do need to correct this can we just go back and correct enough claims to qualify for the incentive or are we required to go back further? I would appreciate any input since we are now on a tight timeframe as far as the attestations. Both physicians are eligible and saw enough patients to qualify for the full incentive.
--- End quote ---

Richard summed it up pretty good:
 
--- Quote ---Type 1 (who did the work) and Type 2 (who gets paid) NPI numbers.  Both must be used on the CMS 1500 form that is submitted to Medicare.  One tells CMS who did the work, and the other tells CMS who gets paid.  In the case of a solo practitioner, both of the NPI numbers provided on the CMS 1500 form belong to him.  In the case where the work was actually performed by a hireling, the CMS 1500 form must contain the Type 1 NPI number for who did the work (the hireling), plus the Type 2 NPI number for who gets paid (the hirer).
--- End quote ---

I'd say you might have to go back and fix things from the very beginning in addition to doing it right now.

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