I apologize if this is long. I work for a state University in their Speech and Hearing Department. I work at the clinic for the department where graduate students, under licensed SLPs, provide speech therapy services to clients. We have recently started accepting health insurance. At this time, we can only submit paper claims as the clinic is shifting to become HIPAA compliant. We are contracted with exactly one health insurance company at this time but are working to add 3 more (1 private and 2 Medicaid). I have come across multiple issues when billing. I was trained one way but as I have read the instructions for the 1500 Claim Form it seems that some of that training is outdated. I will save most questions for when the situation arises but do have a couple that are more general and will ask them here. I hope this is an okay section to ask these questions.
1. For the insurance company which do have a contract with, we have 2 providers who are not individually credentialed at this time. We are working to get this done. In the meantime, we were told that we could bill as the group, under our EIN, and have the services covered. My understanding, from reading the instruction manual for the 1500 Claim form, is that I would put nothing in sections 24I or 24J, in 32a and 33a I would place our facility NPI, and in 33b I would put ZZ along with our taxonomy code. Is this correct?
2. For the same situation as in question one, when we seek to obtain pre-authorization (required) I must select a clinician here who is already credentialed. That person is not signing the claim form. In this situation can the clinician for whom the approval was given sign the form if I complete 24I as ZZ with our taxonomy code and 24J with the NPI for whom the approval was given?
Thank you for any guidance you can provide! I have tried to find possible webinars I could attend where I might learn some of this information but it seems that all of the webinars I could find were for members of associations to which I could not possibly apply for membership.