I'm having a hard time trying to figure out the extent that compliance will want to see when auditing my physician's attestations for INPA split/shared services. What exactly does "in its entirety" mean? What will the auditors specifically be looking for? The new 2023 rules have been very vague in regards to this.
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Wiki Acceptable attestation for split/shared services?
- Thread starter kait.bush@ufl.edu
- Start date
TThivierge
True Blue
Hi Kait 
From what I glean out of reading is who does the most time and documentation on the patient. But then it depends on the setting such as EMR.....nurse does the triage, then EMR doc finishes with documentation and assessment. Or if it is beh health patient the psychiatrist and therapist may treat pt same day but similar issues but one spends more time on the patient. Also there is a modifier for split shared usage too. Billing dept. transmits claims then the insurance payer checks it out by making differ payment amounts or denies one visit. I am not in billing dept. so just guessing. Does any of that make sense?
Lady T
From what I glean out of reading is who does the most time and documentation on the patient. But then it depends on the setting such as EMR.....nurse does the triage, then EMR doc finishes with documentation and assessment. Or if it is beh health patient the psychiatrist and therapist may treat pt same day but similar issues but one spends more time on the patient. Also there is a modifier for split shared usage too. Billing dept. transmits claims then the insurance payer checks it out by making differ payment amounts or denies one visit. I am not in billing dept. so just guessing. Does any of that make sense?
Lady T
jkyles
True Blue
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CMS hasn't released specific guidance but I assume they'll determine if a single provider's documentation shows they performed the entire portion of at least one component of the visit (history, physical or MDM). If it is MDM it should be fairly straightforward because you'd be able to code the visit based on that one provider's documentation.