I hope someone can answer this for me: dialysis billing and Medicaid: Medicaid has a different Provider locked in then what was on the claim. Legally, can I change the provider as long as the provider saw the provider? The two Providers I'm speaking of are in the same practice.
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Changing Provider
- Thread starter allie928@yahoo.com
- Start date
mitchellde
True Blue
It depends on why you billed the claim under the first provider originally. If the dialysis service is being billed as incident to and the Medicaid provider was not in the office at the time of service then no you cannot change it. If the original provide was the one that was present with the patient for this encounter then no you cannot change the provider.
So for dialysis someone from my office see's the patient weekly, we bill for 4 times a month on the MCP. At one time, we would bill under the Provider that was the patient's; now with new changes we bill for the provider who did the comprehensive visit. Dr. P did the comprehensive BUT Dr. D. is the Patient's Provider. I have submitted a revised DMA615 with Medicaid to change the provider but I have 2 claims that are now incorrect.
mitchellde
True Blue
Who is the provider that sees the patient weekly or is in the office if not seen by a provider. So if the answer varies and Dr. P was present for 2 and Dr. D was present for two then you would bill with two line items to account for this. If both providers are present but neither performed a face to face so it is all incident to then it would not matter which provider it is billed under when it is all the same practice