Healthcare Leadership and Innovation

In house Occupational Therapy

  • 1.  In house Occupational Therapy

    Posted 09-11-2020 12:11

    I currently work for Ortho doctors whom also have in house OT. The staff here have been billing commercial payers as follows; They are using the referring ortho doctor as the rendering provider. I advised them that this is wrong but stated that they have been doing it this way and the claims are getting paid. I explained to them that they should be using the Ortho doc as the referring physician and the rendering provider should be the therapist who actually provided the services to the patient. When I brought the issue to our administrator he stated that they were instructed by the commercial payers to bill OT under the ortho doctor. To me "Billing under the doctor" means to use a supervising or referring physician. I told them you could never use the rendering provider as someone who did not actually render the services. Please let me know your thoughts on this because these commercial payers are paying the claims whether we use the Ortho doc as rendering or therapist as rendering with referring or supervising physician.

    Amy Martinez
    Medical Coder