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Covering Provider

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Billing2:
It's been many years since I billed for a covering provider.

It's for a Chiropractic office, I know he has to do all the chart notes and we have his name on the paper work. But the covering provider is trying to tell me he can't code it. He'll write down what he does and when the provider gets back she can code it. I do not want to bill it out if that happens.

I feel that is very wrong. Please HELP.

Also what about the insurances companies? Don’t they need to know he is doing the work?

Before you all ask, no he is not hired though a covering agency. It’s a friend of theirs, who is a License Chiropractor.

DMK:
I'm not understanding why he "can't code it".  He's providing the service so he should know what the procedure code is, and he's making a diagnosis in order to provide the correct service so he should know what the diagnosis code is.  The rendering provider is totally responsible for the services they rendered.  If they got sued, they'd be on the hook, not the doctor who's on vacation.

The rendering doctor's NPI should be on the claim form, but the payment can go to the clinic where services are performed since he is a locum.  HOWEVER, I'm not 100% positive about locum billing because that would mean that the locum would have to be approved by all insurances, and then there's the Medicare sticky wicket.  Hopefully someone far smarter than me will chime in on locum billing.

PMRNC:

--- Quote ---It's for a Chiropractic office, I know he has to do all the chart notes and we have his name on the paper work. But the covering provider is trying to tell me he can't code it. He'll write down what he does and when the provider gets back she can code it. I do not want to bill it out if that happens.
--- End quote ---

The situation of locum or not is moot. IF it's not the responsibility of the billing company to provide coding that is that. ULTIMATELY the provider is responsible, they have 2 choices. Get a coder or code themselves. Refer to your contract if you need to. again the situation (locum or not plays no part in the contracted services you are hired/contracted to do).  If a client sends me something not coded, it goes back, I document I sent it back and it does not get billed until they code it.

Billing2:
I never code. I make all my providers code. It's more he is going to wait and have the provider on vacation code when she gets back.

DMK:
The point is, the doctor on vacation didn't see the patient and didn't provide the service, why would/should she code?

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