Wiki Billing / supervising provider when MD is out of office

[kkorn]

there is an office that has a provider out for three weeks. the nurse has been giving flu vaccines, injections and CLIA waived protimes, they have a PA and NP coming in the office to cover two days of the week. on the days there is not a provider who should the billing and supervising provider be (if we can even submit that)? The days that either the PA or NP are there, can the supervising provider be a provider that does not work at that office (the clinics are part of the hospital)
I cannot find anything real clear on this.
I appreciate your help.

 

[mitchellde]

If the clinic is a part of the hospital then who employs the RN? Usually the ancillary staff are facility employees in this situation but it is a critical question.

 

[CodingKing]

You cannot bill under the name of someone who is not on site. Also incident-to does not apply outside place of service 11

 

[mitchellde]

You cannot bill under the name of someone who is not on site. Also incident-to does not apply outside place of service 11

Yes that is why I was asking. If these are facility employed personnel then the POS would be 22 and the provider would not be billing for any nursing performed activities. The facility would bill that on an outpatient claim.

 

[kkorn]

the staff are employed by the hospital. this particular clinic is POS 11

 

[mitchellde]

To bill incident -to services the person providing the service must be an employee of the provider. The provider you are billing under must be physically in the office setting at the time the service is rendered.
It does not sound like you have met the parameters to be able to bill these services.

 

[kkorn]

I appreciate everyone's input.