Wiki Nurse only vaccine appt

[kholzer13]

We have standing orders for vaccines. Who would be the correct provider to bill these under? The patient only sees the nurse but is placed either in a doctor's or a mid-level's schedule. Should it be billed under the on-call doc since they aren't actually seeing the provider? And if anyone would know where I could locate backup documentation for this so I have it in black and white for my providers and practice administrator. Thanks!

 

[thomas7331]

I'm not aware of any guidelines that would tell you which provider you need to us for billing in this situation. I would use the provider who is most closely associated with the provision of the service - I think that using the physician who is on call and available at the time would be appropriate. The payment is going to the practice, not to the individual provider, and there are no professional work RVUs associated with the administration of a vaccine, so it isn't going to make a difference in payment in any way. It's really just an administrative technicality that you need to have an individual's name on the claim. But payers understand that this type of service is routinely performed by practice staff.