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Chronic Pain Management-Chiropractic

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  • AmLee Billing Services
    I have a question I am hoping the Chiro Billers here will be able to help. If Doctor A was in a group providing Chronic Pain Management for a worker s comp
    Message 1 of 4 , May 3, 2005
      I have a question I am hoping the Chiro Billers here will be able to help.
      If Doctor A was in a group providing Chronic Pain Management for a worker's
      comp patient then leaves this group. I know with Chronic Pain Management you
      have hours of care and on these claims there is group psycho therapy and all
      kinds of other stuff regarding Mental Health of the patient. Doctor A wants
      me bill these group psycho therapy and everything else, but wouldn't that be
      out of the scope of service for a chiropractor? He is no longer with this
      group but wants me to bill this under their tax id. Can you do that? I
      didn't think you could bill for providers under numerous tax ID's. The other
      Doctor that provided the group psycho therapy and stuff is not a client. I
      guess my question would be can you do that? I do not feel that this is
      ethical to bill out of the scope of practice and for other providers that
      are not my clients.

      Amie Pennington-White
    • Michelle Uhl
      I do know you can t bill under someone else s tax id for certain.. in doing this you would be telling the irs that this is income for the other practitioner
      Message 2 of 4 , May 3, 2005
        I do know you can't bill under someone else's tax id for certain.. in doing this you would be telling the irs that this is income for the other practitioner and therefore, they would end up paying taxes on monies the other physician collected.. definately a no-no there..


        AmLee Billing Services <amlee_billing@...> wrote:
        I have a question I am hoping the Chiro Billers here will be able to help.
        If Doctor A was in a group providing Chronic Pain Management for a worker's
        comp patient then leaves this group. I know with Chronic Pain Management you
        have hours of care and on these claims there is group psycho therapy and all
        kinds of other stuff regarding Mental Health of the patient. Doctor A wants
        me bill these group psycho therapy and everything else, but wouldn't that be
        out of the scope of service for a chiropractor? He is no longer with this
        group but wants me to bill this under their tax id. Can you do that? I
        didn't think you could bill for providers under numerous tax ID's. The other
        Doctor that provided the group psycho therapy and stuff is not a client. I
        guess my question would be can you do that? I do not feel that this is
        ethical to bill out of the scope of practice and for other providers that
        are not my clients.

        Amie Pennington-White



        A list where we can all help each obtain maximum reimbursement!

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      • Cyndee Weston
        Amie: Billing for services under another provider s ID would be fraudulent. Even when your chiro was with the group, his services should not have been billed
        Message 3 of 4 , May 3, 2005
          Amie:
           
          Billing for services under another provider's ID would be fraudulent. Even when your chiro was with the group, his services should not have been billed under another provider's ID. If he is performing services outside the scope of his license, those services wouldn't be covered and that is probably why he wants to bill using a different provider's ID. He should bill for what he did using his own ID number. This issue, technically, should be addressed by the compliance officer according to OIG compliance to prevent and detect fraud and abuse. Claims that were filed using another provider's ID should be refiled correctly to mitigate the damage from filing wrongfully and steps should be taken to ensure this type of issue doesn't happen again. I realize you have no control over the other clinic, but this is a situation where the provider has an obligation to rectify the problem. This is why the OIG has strongly suggested the use of an OIG compliance plan.
           
          Cyndee Weston
          American Medical Billing Association
           
           
          -----Original Message-----
          From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com]On Behalf Of AmLee Billing Services
          Sent: Tuesday, May 03, 2005 9:25 AM
          To: Amba; CRN-L; PMOM; Medical-Coding-Billing; MedicalBillers
          Subject: [MedicalBillers] Chronic Pain Management-Chiropractic

          I have a question I am hoping the Chiro Billers here will be able to help.
          If Doctor A was in a group providing Chronic Pain Management for a worker's
          comp patient then leaves this group. I know with Chronic Pain Management you
          have hours of care and on these claims there is group psycho therapy and all
          kinds of other stuff regarding Mental Health of the patient. Doctor A wants
          me bill these group psycho therapy and everything else, but wouldn't that be
          out of the scope of service for a chiropractor? He is no longer with this
          group but wants me to bill this under their tax id. Can you do that? I
          didn't think you could bill for providers under numerous tax ID's. The other
          Doctor that provided the group psycho therapy and stuff is not a client. I
          guess my question would be can you do that? I do not feel that this is
          ethical to bill out of the scope of practice and for other providers that
          are not my clients.

          Amie Pennington-White



          A list where we can all help each obtain maximum reimbursement!

        • AmLee Billing Services
          Thanks Cyndee, I felt it wrong and I am glad I have not done anything with these 5 claims yet. I don t agree with billing for psycho therapy for a
          Message 4 of 4 , May 3, 2005
            Thanks Cyndee, I felt it wrong and I am glad I have not done anything with these 5 claims yet. I don't agree with billing for psycho therapy for a Chiropractor? I have a problem with that. He is also the same client I have been asking about and having problems with so I guess since he has failed to send in payment for services I will just cancel his contract. I don't feel I should keep working for free.
             

            Amie Pennington-White

             


            From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com] On Behalf Of Cyndee Weston
            Sent: Tuesday, May 03, 2005 12:38 PM
            To: MedicalBillers@yahoogroups.com
            Subject: RE: [MedicalBillers] Chronic Pain Management-Chiropractic

            Amie:
             
            Billing for services under another provider's ID would be fraudulent. Even when your chiro was with the group, his services should not have been billed under another provider's ID. If he is performing services outside the scope of his license, those services wouldn't be covered and that is probably why he wants to bill using a different provider's ID. He should bill for what he did using his own ID number. This issue, technically, should be addressed by the compliance officer according to OIG compliance to prevent and detect fraud and abuse. Claims that were filed using another provider's ID should be refiled correctly to mitigate the damage from filing wrongfully and steps should be taken to ensure this type of issue doesn't happen again. I realize you have no control over the other clinic, but this is a situation where the provider has an obligation to rectify the problem. This is why the OIG has strongly suggested the use of an OIG compliance plan.
             
            Cyndee Weston
            American Medical Billing Association
             
             
            -----Original Message-----
            From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com]On Behalf Of AmLee Billing Services
            Sent: Tuesday, May 03, 2005 9:25 AM
            To: Amba; CRN-L; PMOM; Medical-Coding-Billing; MedicalBillers
            Subject: [MedicalBillers] Chronic Pain Management-Chiropractic

            I have a question I am hoping the Chiro Billers here will be able to help.
            If Doctor A was in a group providing Chronic Pain Management for a worker's
            comp patient then leaves this group. I know with Chronic Pain Management you
            have hours of care and on these claims there is group psycho therapy and all
            kinds of other stuff regarding Mental Health of the patient. Doctor A wants
            me bill these group psycho therapy and everything else, but wouldn't that be
            out of the scope of service for a chiropractor? He is no longer with this
            group but wants me to bill this under their tax id. Can you do that? I
            didn't think you could bill for providers under numerous tax ID's. The other
            Doctor that provided the group psycho therapy and stuff is not a client. I
            guess my question would be can you do that? I do not feel that this is
            ethical to bill out of the scope of practice and for other providers that
            are not my clients.

            Amie Pennington-White



            A list where we can all help each obtain maximum reimbursement!



            A list where we can all help each obtain maximum reimbursement!

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