Nov 5th, 2020 - SBerg
Bought out an Existing Practice
A client of ours recently bought out a practice that the doctor did treat the patients before the buy out. The transition with the new tax id took place on Monday and they are performing exams on patients. Since it is a new tax id would the exam be a New patient exam or a re-exam since the doctor performing the services did treat the patient under the prior tax id? Thank you for your time and help.
Nov 12th, 2020 - ChrisW 256 1
re: Bought out an Existing Practice
If the patient is seeing a new provider for the first time (Using a different TAX ID/NPI) I would assume it would fall under the rules for a new provider. In this case, I would suggest verifying what the contract states under the practice buy- out. Something else to consider; is the new provider billing under the old GROUP NPI? Or an individual NPI? He could be billing under an (OLD) GROUP, NPI, and his (NEW) individual NPI. It may also be set up to bill under a Group NPI, unless it is a new patient to the practice.
It depends on how the Physicians are contracted with payers as well. I would recommend consulting with the physician and see how the contract was set up.
Here is an article that may be helpful. https://www.aafp.org/fpm/2003/0900/p33.html#:~:text=Medicare%20has%20stated%20that%20a,face%2Dto%2Dface%20encounters.