So I'm about to start PGY-4 and have been faced with a Hospital/CPEP raising concerns about possible billing limitations because I am still a resident. I wonder if anyone has had to navigate this.
Thank you very much.
Thank you very much.
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Billing while Moonlighting
Started by Vasanervo
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Have they not had anybody ever moonlight before? Residents literally moonlight at hospitals independently in all specialities all the time.
All you generally need to bill is a valid independent state medical license (so not your resident training license, you should have applied for one already if you want to moonlight). Some private insurance panels might require you to be board certified/board eligible but I've never had that be an issue when working with a hospital because you end up billing under the hospital system. The hospital billing/credentialing department should be the one who's navigating this, not you.
If the hospital you are moonlighting in is the same as one you are training out, things get tricky. The hospital is already being paid for training you. So they kind of can't double dip with you moonlighting. If the hospital is large enough they might just pay you and eat the cost. Or they have you as a note monkey, and when the attending rolls in for weekend rounding in the AM (assuming inpatient) they then authenticate your note, and they bill.
Regarding outside your training facility, its up to your moonlighting employer to just get you credentialed. Some insurance companies might not because you aren't BE/BC, but that isn't your problem, its your moonlighting employer problem.
A possible work around is locums... there is a billing code that allows not credentialed docs to bill out to the insurance company using a locums modifier, but that is only good for 90 days, I believe. This isn't a log term solution as most moonlighting is done for 1-2 years while a resident.
Regarding outside your training facility, its up to your moonlighting employer to just get you credentialed. Some insurance companies might not because you aren't BE/BC, but that isn't your problem, its your moonlighting employer problem.
A possible work around is locums... there is a billing code that allows not credentialed docs to bill out to the insurance company using a locums modifier, but that is only good for 90 days, I believe. This isn't a log term solution as most moonlighting is done for 1-2 years while a resident.
Thanks for the suggestions. It's an outside facility. I'll be applying for my state license shortly.
