Wiki Billing for Mid Levels (NP & PA)

[emunoz]

Hello,

If we have credentialed our mid levels with the government plans (Medicare/Medicaid(s)) Should the claim have their NPI on it? How do you handle this with having the supervising physician sign off on chart? Should the mid level just be listed as the servicing provider and the supervising physician name actually be biled out?

Thanks

 

[erjones147]

Do you require your mid levels have their charts signed off/reviewed by an MD?

 

[erjones147]

Do you require that your mid levels have their charts reviewed/signed off by an MD?

 

[emunoz]

Yes, their charts must be signed off by the MD

 

[mitchellde]

If the encounter meets the provisions of incident -to then you may use the MD, NPI in field 24J (rendering provider). If the encounter does not meet incident -to requirements, then you use the NP/PA NPI in field 24J.
incident - to means
the MD has previous examined the patient for the same diagnosis and has a plan of care in that chart note indicating follow up instructions.
the MD is on site (in the office suite area) at the time of the encounter.
The patient has no new complaints
the NP/PA does not alter the plan of care.

 

[emunoz]

Thanks for the clarification!