We recently discovered that our office was billing all of our claims for ARNP's and PA-C's under our single doctor's NPI and Medicare PTAN. We don't think we will be able to meet the incident to rule. Anyone know when Medicare started requiring the ARNP and PAC individual NPI on the claim form? Anyone have any experience in this matter, or know how we go about returning $$$ to Medicare?
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Wiki Medicare & ARNP, PA-C
- Thread starter ERINM
- Start date
mitchellde
True Blue
As far as I know it has always been this way .. prior to NPI it was their license/taxonomy number. I have been doing this for over 30 years and it has always been this rule.
RebeccaWoodward*
True Blue
Page 191 (1st link) provides the standard form for reporting overpayments. Most carriers provide guidance for reporting refunds. I would contact your carrier to find out what would be the best way for handling this since it appears you're going to issue many refunds.
https://www.cms.gov/manuals/downloads/fin106c05.pdf
https://www.highmarkmedicareservices.com/appeals/faq/additional-appeals-op.html
https://www.cms.gov/manuals/downloads/fin106c05.pdf
https://www.highmarkmedicareservices.com/appeals/faq/additional-appeals-op.html