Practice Management Alert

Question: We have several nurse practitioners in our office who perform minor procedures like removing malignant and benign lesions. We just got word that one of the commercial insurance carriers we use says that a doctor must be “intimately involved” in the procedure if we are to receive payment. What on earth does this mean?

AAPC Forum Participant

Answer: This is a situation where reaching out directly to the payer is your best bet because they should be able to point you toward the specific, written policy to legitimize this request. Note that, if the carrier is large and serves many states, the pertinent information may apply only to your state — which makes it even more important to reach out directly to the source.