Medicare Compliance & Reimbursement

Hint: Doctor's schedule will be the key. Under incident-to rules, qualified nonphysician practitioners (NPPs) can treat certain patients and still bill the visit under the doctor's National Provider Identifier (NPI), bringing in 100 percent of the assigned fee for the codes you report. Just make sure you've got the rules down pat before you bill. On-site requirement: To bill a service incident-to, the physician must be present in the office and be immediately available for assistance, consultation, or patient emergencies,should they arise, though not necessarily seeing the patient. "If the insurer ever audits your charts, they will look at the doctor's schedule on the date of the incident- to service," says Heather Corcoran with CGH Billing in Louisville, Ky. "If he was out of the office and your NPP billed incident-to, your insurer will have a lot of questions for you." Tip: Don't assume that just because the physician is [...]