Wiki noncontracted doctor billing 'incident to'

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jliving77

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We have a new doctor starting with our practice soon, and she does have an NPI. She is still in the credentialing process for all the insurance carriers we accept. The problem is, she is replacing a provider who sees a LOT of patients and we can't just schedule our self pay patients with the new dr. because someone needs to see these insured patients. We accept Medicare and AZ AHCCCS (Medicaid).
So my question is, if she works the same hours as our head physician can she bill incident to under him? Provided of course that the incident to rules are met. One other thing, we are a group billing practice and bill under a group NPI in box 32 and 33A. The provider we are billing under goes in box 24J. I don't know where the rendering dr's NPI would go on the claim.
Help!!!:confused:
 
You cannot bill one physician incident another physician. The rendering provider is the one that goes in 24j. The patient that see this provider will be out of network and must be told this prior to the encounter. Or you can try to hold the claims in the hopes that they will make his participation retroactive.
 
noncontracted providers

Thank you for that. Unfortunatly our patients are covered under Medicaid and we can't bill them for anything so it sounds like our provider will not be able to see very many of our patients. :(
Jennifer
 
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