Billing for Hospitalists

Question: We are trying to put together a hospitalist program with a local community hospital, utilizing local practicing physicians. My question is, when the hospital bills on behalf of the hospitalists for their services rendered at the hospital, will third-party payers have difficulty with generating payments to the same physicians who also have their tax IDs for their separate private practices?

Answer: You really need to get the help of the hospital legal staff or a healthcare attorney to be certain you get this right. However, if the hospital and your colleagues are forming a group that will be a billing entity in its own right, then you will have a separate tax ID number.

The individual NPI numbers can be associated with more than one tax ID, as an individual provider can work in a variety of settings and for more than one entity. A given payer’s claims processing software should be able to sort out which tax ID and which providers within that are being paid. The tax ID controls the place the payment is sent in most cases.

Bill Dacey, CPC, MBA, MHA, is principal in the Dacey Group, a consulting firm dedicated to coding, billing, documentation, and compliance concerns. Dacey is a PMCC-certified instructor and has been active in physician training for more than 20 years. He can be reached at billdacey@msn.com or physicianspractice@cmpmedica.com.

This question originally appeared in the June 2010 issue of Physicians Practice.