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oncology bill

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butterfly7:
i am billing for a cancer clinic because of the way their providers are grouped under NPI, certain payers are refusing to pay New Patient E&M rates.  They’re saying the patient has already been seen (like by the provider who issued the diagnosis) and that the first cancer center visit is a follow-up, not an initial. please help

 

Michele:
If they are billing under one group NPI & EIN then that is correct.  The NP visit is only allowed the one time.

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