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Adding NP!!!

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Misil:
Hello,
There's a doctor who wants to add NP under group provider numbers.
The NP is new and not credentialed with any insurance companies.

Questions are:
1. How do I add this NP under a doctor's group medicare number & commercial insurance provider numbers in order to bill?
 
2. After adding this NP under a group id numbers, how do I fill out the CMS 1500 form?
    (In this case, NP will be working and will be billed under group provider numbers.)

3. After adding this NP under group in numbers, can this NP also provide ob/gyn procedures and bill?

Thank you.

RichardP:

--- Quote from: Misil on February 08, 2014, 01:27:24 AM ---There's a doctor who wants to add NP under group provider numbers.
--- End quote ---

I assume that you are saying there is a Doctor's Group (that meets the legal CMS definition of "Group"), with a Group NPI Number, that wants to hire an NP.  If, instead, there is a doctor in the group who wants to hire the NP to work personally for him, let us know that.

Read through all five of these links.  Each comes at the NPI number from a slightly different perspective.  Come back with any remaining questions.

http://www.medicalbillinglive.com/members/index.php?topic=7045.msg21031#msg21031
http://www.medicalbillinglive.com/members/index.php?topic=7272.msg22414#msg22414
http://www.medicalbillinglive.com/members/index.php?topic=7436.msg23215#msg23215
http://www.medicalbillinglive.com/members/index.php?topic=7299.msg22542#msg22542
http://www.medicalbillinglive.com/members/index.php?topic=7418.msg23109#msg23109

This link may or may not be relevant if the NP is bringing patients with them to the new organization.

http://www.medicalbillinglive.com/members/index.php?topic=7343.msg22913#msg22913

Misil:
Yes, there's a doctor's group with a group npi number, that wants to hire a NP to work under him/her.

1. For Medicare, do I have to fill out 855R?

For commercial insurances,
1. what if the doctor has individual provider numbers instead of group provider numbers?
2. Do I have to apply for group provider numbers, then add the np under that group provider numbers?
3. Does the np have to use group npi or his/her individual npi #?

Thank you RichardP for the info.

RichardP:
... there's a doctor's group with a group npi number, that wants to hire a NP to work under him/her.

From one of the links I provided above:

A collection of service providers may come together and form an organization that is a legal entity.  That legal entity must then obtain a Type 2 NPI Number (who gets paid).  All billing would be done in the name of the legal entity, using that legal entity's Type 2 NPI Number.  All payments would be made to the legal entity, and the legal entity would then pay its owners and employees according to a written payment schedule.  In this situation, some insurance carriers (including Medicare) require that the Type 1 NPI Number (who did the work) of the service provider who actually did the work be included when billing.

An organization does not and cannot provide services to a patient (that would be done by a human).  Neither can an organization have a gender.  You say you have a Group, and the Group has it's own Type 2 NPI Number (who gets paid), and then you end your statement by referring to the group as a "him or her".

So - one more time so that our answers might address your actual situation:  are you talking about a legally-created Group, with its own Type 2 NPI Number (who gets paid), that wants to hire a NP, and will pay the NP?  Or are you talking about a real, live person who belongs to that Group that wants to hire the NP, and will pay the NP?

Misil:
A real, live person owns the group PC, and wants to hire the NP to work under him.
Then, the NP will be provide service(s), and will be billed using that live person's group provider number, then will pay the NP.
(Hope this clarify your confusion.)

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