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4737Re: [MedicalBillers] Provider Help

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  • debbie brosnan
    Sep 1, 2009
    • 0 Attachment
      Please email me at my private email off of the forum.
       
      thebiller_2000@...
       


      --- On Tue, 9/1/09, Elsacaer5@... <Elsacaer5@...> wrote:


      From: Elsacaer5@... <Elsacaer5@...>
      Subject: Re: [MedicalBillers] Provider Help
      To: MedicalBillers@yahoogroups.com
      Date: Tuesday, September 1, 2009, 8:04 AM


       



      They are licensed and credentialed to provide Mental Health Support
      Services (H0046), Psychosocial Services and Crisis Stabilization Services (H2019)
      all of which are reimbursed by Medicaid (Medicare does not cover the
      service). However, they have never been licensed to provide any outpatient
      psychological or psychiatric services.
      The owner continues to state that we can bill under the doctor's license.
      I keep insisting that is not the case (which is why he could never get
      paid by the insurance companies for the first 2 years--it was a mess).

      Someone else bills for the other services. I only bill for the doctor's
      services. They now want a full time psychiatrist on staff as an employee.
      But, they need to be licensed and credentialled in order to bill for
      psychiatric services--right?
      I really appreciate your help in this.


      In a message dated 9/1/2009 7:53:16 A.M. Eastern Daylight Time,
      thebiller_2000@ yahoo.com writes:

      Ok from this scenario,

      If he is hired by ABC he is no longer an indepent contractor. He is part
      of a health care facility. Yes the facility would then own the A/R.
      However the facility needs to be licensed and contracted with the payers as a
      licnesed mental health provider in order to bill.

      Is this facility not already credentialed with CMS as a mental health
      provider? Am I reading too much into your explainantion? I have the feeling
      the are not already licensed and credentialled.

      --- On Tue, 9/1/09, _Elsacaer5@aol. Els_ (mailto:Elsacaer5@aol. com)
      <_Elsacaer5@aol. Els_ (mailto:Elsacaer5@aol. com) > wrote:

      From: _Elsacaer5@aol. Els_ (mailto:Elsacaer5@aol. com) <_Elsacaer5@aol. Els_
      (mailto:Elsacaer5@aol. com) >
      Subject: Re: [MedicalBillers] Provider Help
      To: _MedicalBillers@ MedicalBilleMed_
      (mailto:MedicalBillers@ yahoogroups. com)
      Date: Tuesday, September 1, 2009, 7:33 AM

      Thanks for your response.
      I work for a company that provides community based mental health supports,
      so we do no in house counseling services. For the sake of simplicity let's
      call it ABC company. The psychiatrist comes ABC's office 2 days a week
      and provides med management and psychiatric assessments for some of our
      clients. He has been working as an independent contractor and I am billing
      Medicare, Medicaid etc for his services.
      The owner of this company now wants to hire him as an employee. So ABC
      will pay him a salary and use the reimbursement from Medicare, Medicaid
      etc
      to offset his salary. Therefore, ABC now wants the insurance payments paid
      to them, not the doctor as an independent contractor.
      So my question is--do I have to use the ABC's tax ID number and his NPI
      number to bill. Does ABC now need credentialed as a provider of
      psychiatric
      services? I am pretty sure they do, but having a difficult time getting
      the
      owner to understand.
      Thanks again.

      In a message dated 9/1/2009 7:21:01 A.M. Eastern Daylight Time,
      thebiller_2000@ yahoo.com writes:

      Is he hired by the hospital as in, the hospital is now going to pay him a
      salary and the hospital expects his A/R to be turned over to them?

      If this is the case, then once he is hired and credentialed to operate
      through the hospital ( assuming he has not already been credentialed to
      work
      there). then yes you use the facility tax id numbers. The facility would
      also add him to their participating insurance contracts. Once this is
      complete then you would also bill those companies. Besure to find out of
      their
      contracts are NPI only or still under a legacy system.

      To answer the first part of your question. Is yes, once he has completed
      his contracting information with the facility.

      As far as you needing a license. Are you someone he has hired as a
      payroll employee or do you have a company? If you are his employee then no
      you
      dont need a license. If you are a company you should already be licenses
      in
      your state as a business.

      Hope this helps.

      Deb
      --- On Tue, 9/1/09, elsacaer5 <_Elsacaer5@ _Elsacaer5@ <WB
      (mailto:Elsacaer5@ (mailto:El> wrote:

      From: elsacaer5 <_Elsacaer5@ _Elsacaer5@ <WBR>aol. Els_ (m_Elsacaer5@ <WB>
      Subject: [MedicalBillers] Provider Help
      To: _MedicalBillers@ MedicalBilleMed_ (m
      ailto:MedicalBiller ailto:MedicalBil ler<W
      Date: Tuesday, September 1, 2009, 3:25 AM

      I am a mental health worker who has, by default, ended up with the job of
      billing for a psychiatrist who provides services for our clients. I have
      been billing for him as an solo provider (he is finally getting paid).
      However, the company now wants to hire him as an employee.

      Do I now need to bill using the company's provider number? And do we need
      to be liscened to bill for psychiatric services or as an outpatient clinic.

      Thanks

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