Our practice just hired a new physician, but she doesn’t have her Medicare provider number yet. Our biller has applied for it and told me that in the meantime, we can bill my new physician’s office visits under my provider number. Is this legit?

Q:	Our practice just hired a new physician, but she doesn’t have her Medicare provider number yet. Our biller has applied for it and told me that in the meantime, we can bill my new physician’s office visits under my provider number. Is this legit?

A:	The answer is no. This behavior is termed ‘knowing misuse of a provider identification number’ and could be considered a false claim, subject to fines and sanctions. Provider claims must identify the actual practitioner who performed the service. In fact, submission of a claim presupposes that the physician certifies he or she personally rendered the service or attest that the service was furnished incident to the physician’s professional service by an employee under his/her immediate personal supervision. Services rendered by another physician are not subject to ‘incident to’ coding. CMS grants the provider number for the new clinician retroactive 30 days prior to the filing date of the approved application. This means that, in all likelihood, you will only have to hold your billing a short while until you can submit it using the provider number of the clinician who actually rendered the care. Tagged: billing, false claim, Medicare provider number, new physician, rendering provider