When the Doctor is Away, Incident-To Billing is Out of Play

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When your physicians are out of the office, it’s easy to forget taking incident-to billing out of the lineup. Failure to do so, however, is a violation that can land your medical practice in hot water.
What is Incident-To Billing?
Incident-to billing refers to billing services provided by a nonphysician practitioner (NPP), such as a physician assistant, nurse practitioner, midwife, therapist, etc. Qualified NPPs can perform services under the name and National Provider Identifier (NPI) of the supervising physician—providing that the supervising physician is in the office. In this sense, the patient is under the physician’s care, with the NPP serving as a physician extender.
With the supervising physician in the office suite—and immediately available if called upon—medical practices can claim incident-to services performed by a NPP, code the services under the supervising physician’s NPI, and receive maximum allowed payout. The NPP, of course, must have an employment relationship with the physician or the physician’s employing agency.
When the physician is out of the office, services provided by the NPP must be reported under the NPP’s NPI. In this instance, the medical practice will receive only 85% of the allowed payout—which, tongue...

Source: PickTheBrain | Motivation and Self Improvement - August 25, 2017 Category: Consumer Health News Authors: Dillon Tags: featured Source Type: blogs