decisionhealth Newsletters, Coder Pink Sheets - 2017 Issue 3 (March)
Getting paid: If NPP is not yet enrolled in Medicare, only do incident-to billing
Subscribe or sign in to view the full article.
Article Overview
This article addresses Medicare payment and compliance issues that arise when a new non-physician practitioner begins seeing patients before full enrollment or credentialing is complete. It focuses on general billing options, supervision requirements, payer-related risks, and malpractice coverage considerations for practices working with physicians and NPPs. The discussion is aimed at orthopedic practices and other provider organizations that need to understand when services may be billed under a supervising clinician and what operational safeguards matter.
Why This Topic Matters
Practices can face payment denials, refund obligations, or compliance problems if they bill services for an unenrolled or unsupervised practitioner incorrectly. The article helps readers understand the broad Medicare and risk-management issues involved in bringing a new NPP into patient care.
What You Will Learn
- How Medicare enrollment and credentialing status can affect billing for a new non-physician practitioner
- The general role of incident-to billing in practice workflows
- Why supervision, licensure, and payer policy verification matter
- How reimbursement disputes can trigger refund obligations
- Why malpractice and liability coverage should be reviewed when an NPP is practicing
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Orthopedic practice administrators
- Physicians supervising non-physician practitioners
- Non-physician practitioners
Modifiers Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com