Medical Billing Coding - Determining Provider v. Professional, cpt, codes
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Thread Topic: Determining Provider v. Professional
Topic Originator: Britny Coker-Moen
Post Date April 4, 2016 @ 6:05 PM
Determining Provider v. Professional


Britny Coker-Moen
April 4, 2016 @ 6:05 PM Reply  |  Email Friend   |  |Print  |  Top

I am a new legal assistant at a law firm with little (no) experience and I have been assigned lien settlements without training (fun!). I have to differentiate between providers and professionals in order to be sure that they are each getting the appropriate portion of the settlement, however I have no clue how to tell which parties are providers and which are professionals. I've been told that providers are usually hospitals but there are specialty clinics and what not with names that sound like hospitals, and vice versa. It would great if someone could shed some light on this for me.

Michelle
July 14, 2016 @ 9:27 AM Reply  |  Email Friend   |  |Print  |  Top

Provider and professional would be the same, that would be the DR. Facility billing would be the hospital. Dr usually bill on a 1500 form Professional. Hospitals bill UB04 institutional forms.



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