Forum - Questions & Answers
Billing for Employed Physician
Our practice recently hired an MD as an employee. The practice administrator wants us to bill this doctors charges under the owner of the companys name. I do not believe this is legal. Has anyone come across this before and how did you bill out the claims?
Caution
Bill the service under the number and MD who performed the service!
No.
A physician cannot work incident-to another physician. This would be fraud under Medicare guidelines. Health plans require each provider, including mid-levels, to credential prior to providing service to patients. The owner physician can lose his health plans contract.
Charlene Endre-Burgett, MS, CMA (AAMA), CPM, CPC, CMSCS
Administrator, North Scottsdale Family Medicine
Blog: www.charleneburgett.wordpress.com
LinkedIn: www.linkedin.com/in/charleneburgett
billing a new MD under another MD's provider number
Nancy and Charlene have said it all.
Medicare has tightened its enrollment rules, and so it is imperative to get the enrollment process going before the physician starts working.
Any services this physician provides to Medicare or patients with commercial insurances with which you participate are freebies to your practice.