Question about MPN physician inclusion. (California)

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Question about MPN physician inclusion. (California)

Postby spreare on Mon Nov 02, 2009 1:12 pm

I heard somewhere that there was a case where if a physician is listed in an mpn directory for one location, that the MPN has to recognize all locations. For example, Dr. X is on Zenith in El Cajon, but not listed in Escondido for Zenith. can Zenith deny the tx in escondido office? I heard that case from last yr precluded a carrier from doing that..
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Re: Question about MPN physician inclusion. (California)

Postby rider001 on Tue Nov 03, 2009 12:57 pm

I just recieved an F&A that said the opposite. The address has to be an accepted address by the MPN. Perhaps the situation was different. IW was in the middle to two locations and being seen at the location not accepted by the MPN. IW was ordered to the MPN location and billing denied. Not citable. I would be interested in seeing cases to the contrary.
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