Practice Management Alert

Knowing the rules determines 100 percent vs. 85 percent pay. In the office setting, incident-to billing is an essential gear in a practice's reimbursement machine. Each time a nonphysician practitioner (NPP) provides services to a Medicare patient, you should be on the lookout for the opportunity to code the service incident-to the physician. Why? Under incident-to rules, qualified NPPs can treat certain patients and still bill the visit under the physician's National Provider Identifier (NPI), allowing 100 percent of the assigned fee for the codes you report instead of the 85 percent allowance when you bill under the NPP's NPI. But if you aren't following the stringent incident-to billing guidelines, you-re only setting your practice up for lost reimbursement and possible fraud charges. Make sure you-re capturing every dollar your NPPs deserve with these expert tips. 1. NPP Has to Follow Established Plan of Care To qualify for incident-to billing, [...]