toria11
Guru
Could someone please confirm this for me? We're trying to navigate authorization/referral requirement questions while educating our staff on the rules of incident-to billing. If a patient has an HMO and we get a referral/auth for the doctor, then the patient sees the ARNP instead, and the ARNP bills for the visit (not incident-to), the office needs a separate referral/auth for the ARNP, correct? The provider on the auth has to match the provider billing for the visit, from what I understand. I'm sure this varies payer to payer, but that's always been the rule as far as I know.