Provider has two specialties. He has opted out, as a dietician. He is also a licensed acupuncturist. There is no option to opt-out of acupuncture. Claims billed to insurers providing "replacement" plans, deny when acupuncture is billed. Has anyone had a provider with 2 specialties, one that an be opted out of and one which can not? Should the acupuncture be processed, as if he was not opted out? When I check the CMS database, the provider shows opted out with only the dietician specialty listed. I can understand how systems likely just have the NPI numbers, not associated taxonomy codes, with the opt outs. Wondering if I have basis to appeal or if it is a case of opt out of one specialty results in not being able to bill for any,
Thank You!
Dorothy G
Thank You!
Dorothy G