Re: partb-l digest: March 22, 2017

Karen..not sure I am responding properly. The therapist must be identified
with their individual NPI. No difference with therapy billing. Ran into
this two years ago. They weren't billing properly.

Merry

Comments

  • edited June 2017
    Thanks, Merry. Everything I am finding says what you stated.



    It is very possible the printing style of the EOB may be the issue, not sure.



    Thank you for reaching out.



    Karen A. Hurley, BS, CMM, CPC, CNA

    President, HPMSI

    PO Box 409

    Parrish, FL 34219-0409

    Tel: (941) 776-4822

    Fax: (240) 368-0059

    Web: www.hpmsi.com



    Since 1996, Celebrating 20 years of Service to Physicians



    Disclaimer: Advice or comments in this email are specific only to the recipient and the presented issue. It is not intended to be used as a global solution for future similar events. Reproduction of the information requires approval by the author.



  • I do therapy billing in the state of MT and I agree with Merry. We are paid with our group NPI but each individual therapist has their NPI attached to each line item. I would say it’s a EOB printing issue because I know our claims would not even process if both the group and individual numbers were not present.
    Thanks
    Stacey Delser, CPC
    Ortho Montana Business Office Manager
    406-238-6537 (p)
    406-238-6599 (f)

  • edited June 2017
    Thank you, Stacey!



    Karen A. Hurley, BS, CMM, CPC, CNA

    President, HPMSI

    PO Box 409

    Parrish, FL 34219-0409

    Tel: (941) 776-4822

    Fax: (240) 368-0059

    Web: www.hpmsi.com



    Since 1996, Celebrating 20 years of Service to Physicians



    Disclaimer: Advice or comments in this email are specific only to the recipient and the presented issue. It is not intended to be used as a global solution for future similar events. Reproduction of the information requires approval by the author.



  • edited June 2017
    I was finally able to determine that the ‘Easy Print’ EOB printing from Medicare removes the individual NPI of each provider on each line item on a group claim.



    https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/AccesstoDataApplication/Downloads/MedicareRemitEasyPrintDemo41.pdf



    Why it does this and why no one ever asked, I have no idea.



    It makes it difficult for external auditing when reviewing EOB’s – to payments – to documentation.



    The individual NPI of the rendering provider is supposed to appear to the left of the service date. What’s even weirder is that the example in the link above shows the REND PROV column as the first data element, yet they show it blank……….. ?????



    Fortunately, the EOB copies I receive electronically from Medicare don’t do that.



    Karen A. Hurley, BS, CMM, CPC, CNA

    President, HPMSI

    PO Box 409

    Parrish, FL 34219

    Tel: (941) 776-4822

    Fax: (240) 368-0059

    Web: www.hpmsi.com



    Since 1996, Celebrating 20 years of Service to Physicians



    Disclaimer: Advice or comments given in this email are specific only to the recipient and the presented issue. It is not intended to be used as a global solution for future similar events. Reproduction of the information requires approval by the author.





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