The rules and policy surrounding billing for services incident to a physician, and billing for shared visits in the hospital, can be quite confusing. And this confusion is compounded by common misunderstandings—lots of them. For example, many believe it is improper to use the "incident to" benefit when a patient has a new problem. But in fact, for many new problems, it is perfectly appropriate for the claim to be submitted "incident to."
Having denials based on failure to satisfy the "incident to" rules is definitely one of the more common reasons for denials. Although the recoupments are not high dollar amounts, they are so common that in aggregate, they are. In many cases, the service could be billed independently by the non-physician practitioner, in which case the payment is 15% less. So there is often a 15% reimbursement swing.
During this webcast, healthcare attorney David Glaser will clear up the confusion surrounding billing these services by detailing the Medicare regulation and the manual provisions. He'll also explain how these services are often misunderstood by lawyers, consultants and even Medicare contractors. Register now and gain a better understanding of the rules surrounding these commonly billed, and commonly denied, services.
Why This is Relevant:
In most offices, these services are billed hundreds of times a day. Any time an NP or PA sees a patient, there is a chance it is billed incident-to. And having denials based on failure to satisfy the incident-to rules is definitely one of the more common reasons for denials.
- Understand how Medicare covers services incident to a physician, and how shared visits can be used.
- Recognize why the statement, new problems cannot be billed incident-to, is incorrect.
- Recognize how private payers may apply different rules regarding shared visits and incident-to.
- Learn to distinguish between "best practices" and "regulatory requirements."
Who Should Attend:
Those professionals that are responsible for professional billing, including medical auditors, coders, and billers, and compliance, audit and appeal managers, and those employed by hospitals who bill for physician services billed by hospitals.