Medical Billing Coding - Physican Profile with insurance companies, cpt, codes
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Thread Topic: Physican Profile with insurance companies
Topic Originator: Vicki Reynolds, RHIT, CMRS
Post Date May 5, 2008 @ 1:28 PM
Physican Profile with insurance companies


Vicki Reynolds, RHIT, CMRS
May 5, 2008 @ 1:28 PM Reply  |  Email Friend   |  |Print  |  Top

I am working with an MD who is a par provider with the insurance companies and specializies in internal medicine. He also works at a dermatology practice which is not par with the insurance companies. Will this effect his physician profile? Would his rate of reimbursement be based on his current profile? What is the "going" fee schedule for dermatology services performed by a doctor who is licensed in internal medicine ?

Steve Verno
May 22, 2008 @ 9:13 AM Reply  |  Email Friend   |  |Print  |  Top

That is up to each insurance company with reimbursement depending on the contract with the other practice.  My contracts state that any contact that an individual provider has iwith that insurance company is null and void when an employee with our practice and renderin g services with our practice.  Our contract has no reflection on the individual provider when the provider works for his own practice.  We are to be paid per our contract requirements and not that of the individual provider.



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