Medical Billing Forum
General Category => New! => : martin0619 June 09, 2010, 05:19:03 PM
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Can one group NPI be billed through two different clearinghouses? Can one use a clearinghouse and one submit directly to the carrier? Any help with this, would be greatly appreciated.
:)
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No, as each clearinghouse has their own submitter ID, and the same NPI # (Billing Entity'e NPI# in 33) cannot be linked with 2 clearinghouses....at least that it what I was told :)
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I bill direct to some carriers and I use 2 different clearing houses, Office Ally & Availity, all for each provider. So in my experience, if I understand the question correctly, the answer is yes. I have submitter numbers for each clearing house. Most insurance carriers do not require that I even list all the providers I will be billing for. The ones that require separate paperwork signed by the provider, I fill out and submit.
Michele
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Hmmm...Office Ally told me that I could not bill out for a provider that was also being billed out by a differet clearinghouse, as Office Ally has their submitter ID and the other clearinghouse, for example, ABC has their own submitter ID......they told me if I was goping to be using them as a clearinghouse, which I do, NO more claims could be billed out to Medicare, for example, using the 'old biller's ' clearinghouse..............
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maybe michele is talking about using different clearing houses for different providers??? I can't say for the commercials, but I know MEDICARE will not allow the same NPI to be billed under 2 clearinghouses.
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I've never had a problem. I don't use a gazillion clearing houses for each provider or anything, but I have hooked up to do Medicare and left their old one in place because they were cleaning up back billing. I've done that with BCBS as well. I use Availity and Office Ally for all providers, and amazingly haven't run into any issues. <<Knocking very hard on wood!!>>
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I recently ran into an issue where a provider was hooked up with a clearinghouse and when I went to hook to mine they rejected it so the provider has to disconnect with the other. This client is in Pennsylvania, but I am not sure that matters, I was always told ONE clearinghouse per provider UNLESS you are splitting and sending certain claims through one and other claims through another. For example you can use one clearinghouse to send all your BCBS claims and another for all the other carriers. But you can't have Medicare and other carriers going through two clearinghouses. Make sense?