How can a nurse practitioner see patients and bill all claims under the physicians billing information. The NP has provider numbers. Is there anyway this is correct or is there any exception. Even many times he's playing golf and not supervising the NP.

Please help
Thank you in advance

The NP should not be billing under the doctor if he is not seeing the patient.

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Originally Posted by bp1star

How can a nurse practioner see patients and bill all claims under the physicians billing information. The NP has provider numbers. Is there anyway this is correct or is there any exception. Even many times he's playing golf and not supervising the NP.

Please help
Thank you in advance

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Is this legal and is there other ways around it by the physician?

First a NP does not have to have a doctor in the building, many work in out clinics with only a doctor coming in to review files. This will vary by your location ( state) and the rules of practice.

And yes it is very common ( but normally when the NP does not have a insurance provideer number) because it allows the patient to get the insurance company pricing and the patient will not owe a lot of extra money if they don't if the NP does not have a insurance company provider agreement.

Also in some cases the NP may have a provider number with an insurance company but not be on some specific plans, for example BCBS has dozens of policy agreememts some doctors are one somme plans, but may not be on all of them

In fact I had to get my doctor to switch to using the doctors numbers since paying for the NP they did not pay as much and I was stuck paying the doctors officer more money out of pocket,

So do they do this, yes, it is common I have been to at least 4 doctors and have required all of them to do it that way for me to be seen by them

By most insurance standards, NP's are not considered doctors and cannot bill as such. Meaning, though they can professionally see and evaluate a patient, they can only bill it as being "supervised" by a physician... if that physician is present or not. Its really just some silly made-up reason the insurance companies invented to try and dissuade claims.

Even if the doctor is on the golf course, its assumed that the NP could call him/her with a question. That is enough to count as "supervision" of services.

Not only is it common, but for most of the insurance companies in the two states we serve its required for submitting any claims.

I work directly with our billing department- this is something we deal with daily.

I work in a medical billing office. All of our NP's bill under the doctors, because as LearningAsIGo has said, they are not considered doctors. In our office, we do list the billing provider as the doctor, but we list the actual provider as the NP... It is completely legal and is standard practice.