JenAbbottPA Posted March 19, 2013 Share Posted March 19, 2013 My billing manager has recently been "informed" that BCBS does not allow PAs to bill when the doc is out of the office. How can this be true? I know they dont credential PAs but I have always thought that we can bill under the group number if our state supervision laws have been met. In Maryland, that would be "available by electronic means" like phone or email. I know there is no "incident to" with private payers so would it be 100% or 85% reimbursement? I have studied this issue many times over and everytime I think I understand it, something comes up and makes me panic! Please help. Does anyone have any insight?:sadface: Link to comment Share on other sites More sharing options...
coloradopa Posted March 20, 2013 Share Posted March 20, 2013 It sounds like your biller is trying to bill incident to which most privates don't allow. The answer to all questions insurance is to email: michael@aapa.org which will get you Michael Powe the VP for reimbursement. Also if you are an AAPA member under reimbursement on the right side is an area called private payor profiles. This has a profile of the private payors which show if PAs are covered and often gives a phone number such as this for Maryland BCBS: Provider Relations and HMO Networks Management: 800/228-8161 or 800/437-2332 Victoria (contracting): 410/872-3500 Maurice Sawyer: 410/872-3540 Sharon: 800/842-5975 Credentialing: 877-269-9593 There is a bunch more stuff there. Link to comment Share on other sites More sharing options...
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