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Medicare Compliance & Reimbursement

Incident-to Billing:

Shore Up You Incident-to Claims or Face OIG Scrutiny This Year

Published on Tue Jan 31, 2012

Ensure your visit meets 4 criteria before filing an incident-to claim. If you don't know how to correctly bill the services the non-physician practitioners (NPPs) in your office perform, it could cost you more than the 15 percent difference in reimbursement rates. Here's why: As part of its 2012 Work Plan, released last October, the HHS Office of Inspector General (OIG) plans to scrutinize incident-to services. Your best bet for avoiding OIG scrutiny is not to bill incident-to unless you're sure you've met the requirements. Here's what you need to know to keep you practice off the OIG hot list. Learn What Incident-to Means As most practices are aware, under incident-to rules, qualified NPPs can treat certain patients and still bill the visit under the physician's National Provider Identifier (NPI), bringing in 100 percent of the assigned fee. How it works: When an NPP provides a service to a Medicare [...]
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