ASGE members may submit coding inquiries electronically to codingquestions@asge.org. When submitting a question, please allow at least three business days for a response. When submitting inquiries, please include the ASGE member’s name and ID number. Only questions will be accepted and not reports. Below is our featured Coding Question of the Month that could be beneficial to your practice.
Question: We have several providers (three physicians and one nurse practitioner) joining our practice. Payor credentialing is slow. Due to this limitation, it is difficult to find enough patients to fill our new providers’ schedules.
We are trying to combat this issue by seeing whether there are any restrictions on pairing a new provider with a supervising provider’s schedule, having both providers sign the note and billing under the credentialed provider. Is this allowed?
Answer: This is one of the Office of Inspector General‘s top issues: “Knowing misuse of provider identification numbers, which results in improper billing.”
Example: A new provider is still not credentialed. The practice administrator works around the delay in credentialing by billing services under the ID number of another provider in the practice. This is considered a false claim because providers may not submit claims without their own identification number.
The best practice is to begin the credentialing process as soon as you have a signed employer contract and do not delay.