# NP Billing Question



## clawler (May 13, 2009)

We have and NP that has started working with our group.  She does not have ANY numbers.  Do we bill under the physicians ID number until her numbers are issued?  

Thanks!


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## mitchellde (May 13, 2009)

Only if they meet the definition of incident to, meaning followp encounters while the physician is on site.


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## clawler (May 13, 2009)

Thank you.  I read the incident to quidelines and we do not qualify.  I hvave found out that the physician is seeing patient's with our NP so I know how to bill for that.  I do not know how to bill when she starts seeing patients by herself or even if she is allowed to until she has an NPI, PTAN, etc...


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## RebeccaWoodward* (May 13, 2009)

"Incident to" applies to Medicare, however, some commerical carriers follow these guidelines. Many commerical carriers have their own policies for credentialing NPPs and providing reimbursement for their services. Some plans credential NPPs and allow their services to be billed under the NPPs' provider number. Other plans do not and instruct practices to bill for services provided by NPPs using the physicians name and NPI number.  I would check with your commerical carriers to see what the billing requirements are for your midlevels.


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## Candice_Fenildo (May 17, 2009)

When and if your NP gets his/her own provider numbers you will bill out to medicare, (Im assuming that you will be credentialing with medicare) under his/her own Provider number/NPI. you will be reimbursed 85%of the Medicare Allowable, there are other commercial insurance companies that have there own definitions of incident to. so it would be best to check with your provider reps. 

hope this helps


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## GAILWILLIAMS (Jun 17, 2009)

*Npp insurance filing*

We have an npp. She has her own npi number, medicare number and medicaid number.  However, with commercial insurance companies, we file under the doctor who is on call or in the office on the specific dates in question.  Each carrier may have their own specs and you might want to verify with the carrier.::d

G.WILLIAMS, CPC, SCP-OBGYN


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## GAILWILLIAMS (Jun 17, 2009)

*Npp insurance filing*

We have an npp. She has her own npi number, medicare number and medicaid number.  However, with commercial insurance companies, we file under the doctor who is on call or in the office on the specific dates in question.  Each carrier may have their own specs and you might want to verify with the carrier.::d

G.WILLIAMS, CPC, SCP-OBGYN


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## teejae07 (Sep 1, 2009)

Would a PA fall under the same catagory?  Follow up with each carrier?


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## LLovett (Sep 1, 2009)

Yes, PA billing is very similar to NP, it will vary carrier to carrier and state to state based on their scope of practice.

Medicare classifies NPs and PAs as NPP (Non Physician Practicioners).

Laura, CPC, CEMC


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