Avoid a costly incident: 4 tips to thwart incident-to billing mistakes

Why This Topic Matters

Incident-to billing can affect Medicare reimbursement and compliance risk, so misunderstanding the rules may lead to payment problems or audit exposure. The article helps readers recognize the operational and documentation areas that commonly trigger concern.

Article Sections

1. Incident-to billing and the OIG case context

   Introduces the compliance issue and places it in the context of a recent federal investigation and settlement involving Medicare claims.

2. Supervision and compliance concerns

   Explains the importance of physician supervision and why the topic draws attention from government payers and investigators.

3. Paying ‘doctor dollars’

   Discusses the reimbursement difference between billing under a physician versus a nonphysician practitioner and why practices monitor this area closely.

4. Follow the golden rule

   Covers the first compliance theme presented in the article, centered on maintaining a consistent plan of care and proper physician involvement.

5. Watch your documentation, including signatures

   Addresses recordkeeping expectations and why signatures and supporting documentation can raise questions during review.

6. Pay attention to your physical presence

   Focuses on the practical issue of where the supervising physician must be during the reported service and the compliance implications of separation.

7. Make a business decision

   Summarizes the operational choice practices face when deciding whether to use incident-to billing or have services billed separately.