Inpatient Consults Billing Question under Own Company

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milomoneepood

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Hello all. A newbie attending (PM&R/Pain) who has a newly formed single member LLC. Just got off the phone with a new billing company I recently signed with. I have started to build inpatient consults at a hospital as a solo physician (maybe soon with extenders). The billing company asked me if I want to bill under my individual NPI or my group (my single member LLC) NPI. For liability purposes, I told the billing company I want to bill under my LLC group NPI - plus I don’t have to be in-network for inpatient consults anyways. The company then asked me if my LLC has been credentialed by the hospital to see the patients (????). I told the billing company the hospitals never asked me for my NPI when I got credentialed, and the billing company says NPI’s are public information so they don’t have to since they look my NPI info up online.

I have colleague physicians who come (or whose extenders come) to the hospital to do inpatient consults, and bill under the physician’s group. I have always done credentialing applications for myself as the doctor to request privileges as my own specialty provider… and hospitals have never asked me to provide my group (company)’s name.

Am I missing something, or this billing company just is not yet familiar with how inpatient consults billing works?

Isn’t it possible to bill under my company when I as the pain physician do (or when my extender does) inpatient pain consults?



This billing company “strongly recommended” that I find a business coach or colleague providers to ask such questions since they’re a billing company who focus on submitting claims and receiving payments… I’m starting from here…


Thank you very much.
 
Sounds like you have an inexperienced billing company. If you are a private practice, with an EIN number, you must bill under the group NPI. I agree that at no point would the hospital ask for anything regarding your private practice. Is your billing company based in the US? Sounds like they are strictly claim submitters and not revenue cycle managers. Feel free to send me a private message with any questions. I have owned a revenue cycle management company for 22 years and can at least point you in the right direction.
 
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