Questions for Dr. Stern
About Your Urgent Care Center
28. We will begin billing for a free-standing urgent care facility shortly, and have been told that the doctors providing services in the facility are not required to have their names on the claim forms, but only the facility as that is the provider. According to other information we have sought after and found, the provider's name should be on the claim form (CMS 1500) and should be linked to the facility that is credentialed by the payer. Would you be able to verify if this is correct? We would really appreciate your expert advice!!! Thank you!!!!
Most payors (including Medicare) require both the physician number and the facility number. A few payors may credential your urgent care center as a facility and may not require a provider number on the claim. This is very contract specific and payor specific.
