Medical Billing Coding - Billing for out of state provider, cpt, codes
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Thread Topic: Billing for out of state provider
Topic Originator: Lorie
Post Date October 24, 2008 @ 12:15 PM
Billing for out of state provider

October 24, 2008 @ 12:15 PM Reply  |  Email Friend   |  |Print  |  Top

I own a medical billing business in florida. I was recently contacted by a doctor who saw my ad on the internet from Kentucky. He is a chiropractor. Can I do billing for him??  Thanks for your help

October 27, 2008 @ 5:14 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Lorie,

My company currently bills for a Chiro in northern Kentucky.  We are located in Arizona.  What makes this possible for us is that we use Kareo, a web based software that allows us to bill anywhere in the country.  We also take the time to learn the specifics of billing in other states.   We have a contract out to a potential client in N.C., and have billed for a Chiro in Chicago.  The problem with Chiros, is that they need to have a compliance officer, but they would rather have a "complaints offficer."  We insist on HIPAA compliance from all of our providers, and drop those that refuse.

We also have a large client in another state.  That state is a very intense learning invironment but we do a great job for our client!

All of our clients see an increase in their revenue when we take over the billing, but one client saw a 31% increase this past year because we studied the billing issues of their state from their last billing company, and did the billing correctly.

Can you bill in Kentucky?  You decide.  Check out the insurance regulations for that state, like you would for Florida.

My opinion---You can do it!

Dan Young
Resolutions Billing & Consulting, Inc.

October 28, 2008 @ 9:24 AM Reply  |  Email Friend   |  |Print  |  Top

Thanks for your response, Dan!!

steve verno
October 28, 2008 @ 3:44 PM Reply  |  Email Friend   |  |Print  |  Top

Dan is right,

You csn do billing for any provider anywhere in the world.

You mayl need to become familiar with the following:

a)  Provider's insurance contracts
b) Contracted carrier chiro policies
c)  State HMO laws
d)  State workers comp laws.
e)  The State Medicaid Provider Rules on Chiro billing
f)  The local Medicare Chiro LCDs

YOU may also want to check with your clearinghouse to see which carrriers they send claims to in that State.

YOu may have to register with the Medicare and/or Medicaid in the state as a billing agent.

October 28, 2008 @ 4:08 PM Reply  |  Email Friend   |  |Print  |  Top

Thanks, Steve. Thanks also for reminding me to check it out with the clearinghouse I use for electronic claims!!

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