Medical Billing Forum
Billing => Billing => : SLNathan September 30, 2020, 02:53:07 PM
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We are sending insurance forms to a client where the psychologist is billing under a supervisor's NPI in NY State. Oxford is denying the claim stating that services performed by an individual must be billed under the individuals NPI and not a supervisor's NPI. Does Oxford always say this or could it be dependent on this particular insurance plan? Are we billing in an unethical way? Is there a different way to submit the claim for the client?
Thank you
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Why is the psychologist billing under the supervisor?
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because she doesn't have an NPI. Why she doesn't, I don't know. Its easy enough to get right and takes a few months?
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It takes a few minutes to get an NPI if you do the online application. One provider cannot use another provider's NPI for billing simply because they don't have one. If they are doing an internship, or some other situation where they require supervision, then they can bill under the supervisor, but I'm not sure that's the case here. Does the provider require supervision? Do they have a limited license? If it's just because they don't have an individual NPI I would look into getting one ASAP. Then they will have to be credentialed with the insurances.
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https://nppes.cms.hhs.gov/#/ this is the website to apply for the NPI.