Medical Billing Coding - can a provider be both in and out of network., cpt, codes
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Thread Topic: can a provider be both in and out of network.
Topic Originator: JP
Post Date February 11, 2013 @ 6:48 PM
can a provider be both in and out of network.

February 11, 2013 @ 6:48 PM Reply  |  Email Friend   |  |Print  |  Top

I am currently a employee provider (MD) in a all out of network practice (A).  I am thinking of moonlighting and starting my own Consultant solo practice (B) where I plan on being in-network with the major insurance providers.   If I become contracted with the insurance companies will it preclude my practice (A) being able to bill out of network for my services as an employee?

opionions and rationale would be appreciated.

February 26, 2013 @ 8:25 PM Reply  |  Email Friend   |  |Print  |  Top

Yes, you can set up a practice the way you describe. When your claims go out under the facility you are working at as an employee, they go out with the NPI and Tax ID# of the corporation you are working for. If you got contracted under your own name with your own NPI and tax id# you could bill for your own office with no conflict.

Email me at and I can tell you exactly how the claims go out, which information is supposed to show in what fields and what you're going to need. It is just too much info to put here.

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