Re: Medicare -- switching from group to solo/group

[Guest guest]

I't been several years since I left a group practice, so I can't remember the number of the Medicare form, but it's a packet that changes your tax ID number with them - from the groups practice's to your own. It also changes the practice location - was the usual 30 or so pages. Now perhaps you can just use the national provider ID number for the switch. It took about 3 months to go through, but I was able to backbill for everything, because of the Medicare 18 month billing window. It was available on line to download. Most of the other insurances made me recredential, but check with your provider rep at the insurance company - maybe you can talk them into just changing your address and ID number; I think United and one other handled it that way.  Anyone with experience with switching insurances and Medicare, inparticular, from group practice to a solo/group practice?I'm going from a Family Medicine Group practice with 4 docs (including mywife and I).My wife and I will be setting up our own practice with just the 2 of us.All the forms, NPI #'s, etc, make it confusing.Thoughts? Locke, MDBasalt, COUniversity of Kansas Medical School 1991Eau (WI) Family Medicine Residency 19945 Years in Air Force -- [Laughlin AFB (Del Rio, TX) // Spangdahlem AB,Germany]Alpine Medical Group -- Private Group Practice since 1999http://www.alpinemedical.mdJob Share w/ WifeAMG went independent from hospital MSO 10/04AMG made downpayment on Centricity EMR 12/04AMG went "live" with Centricity EMR 15 April 2005

[Guest guest]

I'm in the exact same boat - I called Medicare - and the larger insurer here - and they informed me the numbers are the same and for the insurer - I have a simple form to do to redirect payments and to establish me as an independent....they've sent me a package to review ...but I'm 6 months from launch.....and so await information eagerly. AdamLocke's in Colorado wrote: Anyone with experience with switching insurances and Medicare, inparticular, from group

practice to a solo/group practice?I'm going from a Family Medicine Group practice with 4 docs (including mywife and I).My wife and I will be setting up our own practice with just the 2 of us.All the forms, NPI #'s, etc, make it confusing.Thoughts? Locke, MDBasalt, COUniversity of Kansas Medical School 1991Eau (WI) Family Medicine Residency 19945 Years in Air Force -- [Laughlin AFB (Del Rio, TX) // Spangdahlem AB,Germany]Alpine Medical Group -- Private Group Practice since 1999http://www.alpinemedical.mdJob Share w/ WifeAMG went independent from hospital MSO 10/04AMG made downpayment on Centricity EMR 12/04AMG went "live" with Centricity EMR 15 April 2005

Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.

[Guest guest]

,

When I did this in Colorado, it was easy with the three

insurances I continued working with – PacifiCare, United, and

Kaiser. I spoke with the provider relations person with each of them,

explained I was going solo, and got everything changed to my new info. I

did have to complete their forms, but there was not the same delay as one

experiences starting off new to them. The biggest problem I had was

cancelling the other contracts – my prior group did not do it as they

said they would, so people were (mis)informed that I was still taking their

insurance, when I wasn’t.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From: [mailto: ] On Behalf Of Locke's in Colorado

Sent: Saturday, September 09, 2006

2:31 PM

To: 'Practice Management Issues';

Subject:

Medicare -- switching from group to solo/group

Anyone with experience with switching insurances and

Medicare, in

particular, from group practice to a solo/group practice?

I'm going from a Family Medicine Group practice with 4 docs (including my

wife and I).

My wife and I will be setting up our own practice with just the 2 of us.

All the forms, NPI #'s, etc, make it confusing.

Thoughts?

Locke, MD

Basalt, CO

University of Kansas

Medical School

1991

Eau (WI)

Family Medicine Residency 1994

5 Years in Air Force -- [Laughlin AFB (Del Rio, TX) // Spangdahlem

AB,

Germany]

Alpine Medical Group -- Private Group Practice since 1999

http://www.alpinemedical.md

Job Share w/ Wife

AMG went independent from hospital MSO 10/04

AMG made downpayment on Centricity EMR 12/04

AMG went " live " with Centricity EMR 15 April 2005

[Guest guest]

I just did this about a year ago, I've been open 9 months now. Medicare told me it was all the same numbers, but it really wasn't, my tax id changed as my former partner is still working under the old one. It is ALMOST the same though- one digit different and even when they sent me the new one I didn't catch the change right away. The form to change is pretty simple though and should be available from the local medicare contractor's website. Maybe you can just use an npi now, that would make life simple. I also think the number wouldn't change if you were billing as individuals at the old practice (ie not incorporated and each just using your social security number) but that doesn't seem likely.

I take several other insurances and despite filling out all the paperwork requested by them, this alone taking a lot of time, I still had some mixups once I opened and started billing. I called all the companies the week before I started, spoke to their physician reps, was told I was good to go and yet... Medicare and a couple small companies corrected the issues and paid me. I opened in January and everything was pretty well straightened out by May. United Healthcare has refused to pay me for the first month I was seeing patients. This was for a mistake made by them in the loading of my paperwork. Initially it was 3 months they refused and I have whittled it down to one, but they never did budge. So... good luck!

[Guest guest]

- I did this 2 years ago, I remember medicare being the biggest

hassle. I needed to apply for new individual and group provider numbers, and

it took more than 6 months for them to come through. Apparently I could not

use the previous group and individual number that I had. You can download

the 60 page application and send it and then cross your fingers. I think

they state they are supposed to be able to get you a new number within 3

months, but they don't. They are way backlogged. It may not matter than

much though, since you have one year to submit the claims after the date of

service. (I got a big check a number of months after I had opened.) Just

matters for cash flow issues, if you have a big medicare population. If you

are solo, you need just an individual number but if you are billing through

your practice you need both an individual and group number.

One pitfall with the medicare application that I fell for was to send the

CLIA application to Medicare, along with the Medicare application. Even

though you download it with the medicare stuff, it doesn't go to them, in

RI it goes to the state health department somewhere. I waited for that

number for a year before I finally figured out it wasn't coming and called

around to see what was up.

CAQH- the universal credentialing organization- is a good place to have

your information up to date within, many of the smaller insurances and I

think also United use their information. It's just one central repository

of the usually asked questions and information for credentialing which they

remind you to keep up to date every 3 months, and the insurers go to them.

United and BCBS were no problem, just sent them a letter in writing that I

was changing practices and they accepted that; they just tie your new tax ID

number to your existing provider number.

Good luck- I've been reading your posts on the list serve and wondering

when the jump was going to occur!

Lynn

> _____

>

>From:

>[mailto: ] On Behalf Of Locke's in

>Colorado

>Sent: Saturday, September 09, 2006 2:31 PM

>To: 'Practice Management Issues';

>Subject: Medicare -- switching from group to

>solo/group

>

>

>

>Anyone with experience with switching insurances and Medicare, in

>particular, from group practice to a solo/group practice?

>

>I'm going from a Family Medicine Group practice with 4 docs (including my

>wife and I).

>

>My wife and I will be setting up our own practice with just the 2 of us.

>

>All the forms, NPI #'s, etc, make it confusing.

>

>Thoughts?

>

> Locke, MD

>Basalt, CO

>University of Kansas Medical School 1991

>Eau (WI) Family Medicine Residency 1994

>5 Years in Air Force -- [Laughlin AFB (Del Rio, TX) // Spangdahlem AB,

>Germany]

>Alpine Medical Group -- Private Group Practice since 1999

>http://www.alpineme <http://www.alpinemedical.md> dical.md

>Job Share w/ Wife

>AMG went independent from hospital MSO 10/04

>AMG made downpayment on Centricity EMR 12/04

>AMG went " live " with Centricity EMR 15 April 2005

>

>

>

[Guest guest]

,

We have found changes in medicare group number, addresses, corporate

name, etc to be very cumbersome and frustrating. Even though we

attempted to start the process at least 2-3 months ahead of time.

Even just to change a practice location! The EOBs and payments state

on the envelope " Cannot Forward to another address " hence PO must

return them to sender. Some practices chose to have EOB's sent to a

PO box so they can continue to use it even if they change office

address. There was a definite cash flow issue for about 4 - 6 months!!

We were given wrong advice by some of the medicare personel we spoke

with. When we finally filled out the correct forms we were told they

go on the bottom of a stack on someones desk and it could take a few

more months to get to it. This was all just to change an address

field on a computer data base!! This is a story that gets repeated

often.

We actually ended up calling our US Senator's office and they made

a call to our medicare office (Empire BCBS of NY)and things seem to

move along at that point. Coincidental? Maybe. The person at

senator's office said we were not the first office to complain to

them about the delay in making changes.

HMO's were just the opposite. Usually just a phone call and

change is made immeadiately. Some required you to fax a letter in

writing. Very easy.

Mike Safran

> Anyone with experience with switching insurances and

Medicare, in

> particular, from group practice to a solo/group practice?

>

> I'm going from a Family Medicine Group practice with 4 docs

(including my

> wife and I).

>

> My wife and I will be setting up our own practice with just the 2

of us.

>

> All the forms, NPI #'s, etc, make it confusing.

>

> Thoughts?

>

> Locke, MD

> Basalt, CO

> University of Kansas Medical School 1991

> Eau (WI) Family Medicine Residency 1994

> 5 Years in Air Force -- [Laughlin AFB (Del Rio, TX) // Spangdahlem

AB,

> Germany]

> Alpine Medical Group -- Private Group Practice since 1999

> http://www.alpinemedical.md

> Job Share w/ Wife

> AMG went independent from hospital MSO 10/04

> AMG made downpayment on Centricity EMR 12/04

> AMG went " live " with Centricity EMR 15 April 2005

>

>

>

>

>

>

> ---------------------------------

> Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls.

Great rates starting at 1¢/min.

>

[Guest guest]

Hello from another KU graduate,

The process is cumbersome. If you will be incorporated, many of the

companies will want a copy of your articles of incorporation, they

also want a w9 form.

We had payments go to the old group number at times. You definitely

will need all the details of the practice when requesting the

changes.

Brent Hrabik

> > Anyone with experience with switching insurances and

> Medicare, in

> > particular, from group practice to a solo/group practice?

> >

> > I'm going from a Family Medicine Group practice with 4 docs

> (including my

> > wife and I).

> >

> > My wife and I will be setting up our own practice with just the 2

> of us.

> >

> > All the forms, NPI #'s, etc, make it confusing.

> >

> > Thoughts?

> >

> > Locke, MD

> > Basalt, CO

> > University of Kansas Medical School 1991

> > Eau (WI) Family Medicine Residency 1994

> > 5 Years in Air Force -- [Laughlin AFB (Del Rio, TX) //

Spangdahlem

> AB,

> > Germany]

> > Alpine Medical Group -- Private Group Practice since 1999

> > http://www.alpinemedical.md

> > Job Share w/ Wife

> > AMG went independent from hospital MSO 10/04

> > AMG made downpayment on Centricity EMR 12/04

> > AMG went " live " with Centricity EMR 15 April 2005

> >

> >

> >

> >

> >

> >

> > ---------------------------------

> > Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls.

> Great rates starting at 1¢/min.

> >

>

[Guest guest]

Fair warning to Adam and Locke's -- your UPIN stays the same, but

you have to set up a new Medicare number for yourself tied to that

UPIN, and if you have a practice entity with its own tax ID #

(corporation, partnership, etc.), it has to have its own Medicare

number. LOTS of paperwork!!

The form for redirecting payments is very important, to discontinue

payments to your previous " common pay number " and start them to

yourself or your practice entity.

The forms to establish you as an independent are about 30 pages, as

said. They look mind-boggling, but if you go through one by

one, using the directions that come with them, it works out. It

would be worth asking your Medicare intermediary if you can have

just your NPI since Medicare's transition to using NPI starts Oct.

2, and by May 22 '07 supposedly only NPI's will be accepted.

I found the customer support staff at my Medicare intermediary

surprisingly friendly and helpful. I think they must have found the

experience of a doctor calling personally and asking for help quite

pleasing.

Best of luck - Terry Merrifield, Andover KS

> Anyone with experience with switching insurances and

Medicare, in

> particular, from group practice to a solo/group practice?

>

> I'm going from a Family Medicine Group practice with 4 docs

(including my

> wife and I).

>

> My wife and I will be setting up our own practice with just the 2

of us.

>

> All the forms, NPI #'s, etc, make it confusing.

>

> Thoughts?

>

> Locke, MD

> Basalt, CO

> University of Kansas Medical School 1991

> Eau (WI) Family Medicine Residency 1994

> 5 Years in Air Force -- [Laughlin AFB (Del Rio, TX) // Spangdahlem

AB,

> Germany]

> Alpine Medical Group -- Private Group Practice since 1999

> http://www.alpinemedical.md

> Job Share w/ Wife

> AMG went independent from hospital MSO 10/04

> AMG made downpayment on Centricity EMR 12/04

> AMG went " live " with Centricity EMR 15 April 2005

>

>

>

>

>

>

> ---------------------------------

> Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls.

Great rates starting at 1¢/min.

>

[Guest guest]

We open this month and are experiencing all of this stuff right now, wondering which insurances will kick in and which won't as they slowly trickle in. Only thing I would add is that if you use an electonic billing company, we're using Zirmed, they said add another 2 weeks for commercial carriers to process an electronic filing number and medicare/caid an extra 4 to 6 weeks. That's something we didn't factor in. Has anyone else found this to be the case?

Kari

Re: Medicare -- switching from group to solo/group

Fair warning to Adam and Locke's -- your UPIN stays the same, but you have to set up a new Medicare number for yourself tied to that UPIN, and if you have a practice entity with its own tax ID # (corporation, partnership, etc.), it has to have its own Medicare number. LOTS of paperwork!!The form for redirecting payments is very important, to discontinue payments to your previous "common pay number" and start them to yourself or your practice entity. The forms to establish you as an independent are about 30 pages, as said. They look mind-boggling, but if you go through one by one, using the directions that come with them, it works out. It would be worth asking your Medicare intermediary if you can have just your NPI since Medicare's transition to using NPI starts Oct. 2, and by May 22 '07 supposedly only NPI's will be accepted.I found the customer support staff at my Medicare intermediary surprisingly friendly and helpful. I think they must have found the experience of a doctor calling personally and asking for help quite pleasing.Best of luck - Terry Merrifield, Andover KS> Anyone with experience with switching insurances and Medicare, in> particular, from group practice to a solo/group practice?> > I'm going from a Family Medicine Group practice with 4 docs (including my> wife and I).> > My wife and I will be setting up our own practice with just the 2 of us.> > All the forms, NPI #'s, etc, make it confusing.> > Thoughts?> > Locke, MD> Basalt, CO> University of Kansas Medical School 1991> Eau (WI) Family Medicine Residency 1994> 5 Years in Air Force -- [Laughlin AFB (Del Rio, TX) // Spangdahlem AB,> Germany]> Alpine Medical Group -- Private Group Practice since 1999> http://www.alpinemedical.md> Job Share w/ Wife> AMG went independent from hospital MSO 10/04> AMG made downpayment on Centricity EMR 12/04> AMG went "live" with Centricity EMR 15 April 2005> > > > > > > ---------------------------------> Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.>

[Guest guest]

I've been dealing with the same hassles. It's amazing to me that I send multiple faxes, follow up and still have been told that my tax ID was changed in one system but not the other etc. So, I haven't even started this process with Medicare yet. I don't anticipate having many medicare patients. If I never change my tax ID with medicare from my old group practice ID do I have to go through the hassle of opting out? I guess it may be an issue if a medicare patient want to see me? Thanks, Moitrilynn ho wrote: - I did this 2 years ago, I remember medicare being the biggest hassle. I needed to apply for new individual and group provider numbers, and it took more than 6 months for them to come through. Apparently I could not use the previous group and individual number that I had. You can download the 60 page application and send it and then cross your fingers. I think they state they are supposed to be able to get you a new number within 3 months, but they don't. They are way backlogged. It may not matter than much though, since you have one year to submit the claims after the date of service. (I got a big check a number of months after I had opened.) Just matters for cash flow issues, if you have a big medicare population. If you are solo, you need just an individual number but if you are billing through your

practice you need both an individual and group number.One pitfall with the medicare application that I fell for was to send the CLIA application to Medicare, along with the Medicare application. Even though you download it with the medicare stuff, it doesn't go to them, in RI it goes to the state health department somewhere. I waited for that number for a year before I finally figured out it wasn't coming and called around to see what was up.CAQH- the universal credentialing organization- is a good place to have your information up to date within, many of the smaller insurances and I think also United use their information. It's just one central repository of the usually asked questions and information for credentialing which they remind you to keep up to date every 3 months, and the insurers go to them.United and BCBS were no problem, just sent them a letter in writing that I was changing practices and they accepted

that; they just tie your new tax ID number to your existing provider number.Good luck- I've been reading your posts on the list serve and wondering when the jump was going to occur!Lynn> _____>>From: >[mailto: ] On Behalf Of Locke's in>Colorado>Sent: Saturday, September 09, 2006 2:31 PM>To: 'Practice Management Issues'; >Subject: Medicare -- switching from group to>solo/group>>>>Anyone with experience with switching insurances and Medicare, in>particular, from group practice to a solo/group

practice?>>I'm going from a Family Medicine Group practice with 4 docs (including my>wife and I).>>My wife and I will be setting up our own practice with just the 2 of us.>>All the forms, NPI #'s, etc, make it confusing.>>Thoughts?>> Locke, MD>Basalt, CO>University of Kansas Medical School 1991>Eau (WI) Family Medicine Residency 1994>5 Years in Air Force -- [Laughlin AFB (Del Rio, TX) // Spangdahlem AB,>Germany]>Alpine Medical Group -- Private Group Practice since 1999>http://www.alpineme <http://www.alpinemedical.md> dical.md>Job Share w/ Wife>AMG went independent from hospital MSO 10/04>AMG made downpayment on Centricity EMR 12/04>AMG went "live" with Centricity EMR 15 April

2005>>>

Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.

[Guest guest]

Moitri- I guess you would have to decide if you are aren't taking medicare

patients. If you are not going to take ANY then it probably doesn't matter,

you are not required to take their patients even though you have a number.

If you even take ONE, you will not be paid for that ONE- I would assume

payment would go to your old group. Probably also illegal to see ONE and

bill for it since you are not with the old group and your address etc is not

the same.

Lynn

>

>Reply-To:

>To:

>Subject: RE: Medicare -- switching from group to

>solo/group

>Date: Mon, 11 Sep 2006 16:10:12 -0700 (PDT)

>

>I've been dealing with the same hassles. It's amazing to me that I send

>multiple faxes, follow up and still have been told that my tax ID was

>changed in one system but not the other etc.

>

> So, I haven't even started this process with Medicare yet. I don't

>anticipate having many medicare patients. If I never change my tax ID with

>medicare from my old group practice ID do I have to go through the hassle

>of opting out? I guess it may be an issue if a medicare patient want to

>see me?

>

> Thanks,

> Moitri

>

>

>---------------------------------

>Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates

>starting at 1¢/min.