Sharpen your billing after MACs warn practices to clean up incident to

Why This Topic Matters

Incident-to billing can create compliance risk and repayment exposure if services are billed under the wrong practitioner or without required supervision. Understanding the article helps practices reduce improper claims, respond to MAC review activity, and align billing processes with Medicare expectations.

Article Sections

1. Incident-to billing enforcement and review activity

   This section introduces recent settlement and contractor review activity involving Medicare incident-to billing. It sets out the compliance concerns driving the article.

2. MAC audit findings and problem areas

   This section summarizes observations from multiple Medicare administrative contractors and the types of incident-to claims drawing attention. It focuses on broad patterns in office visit billing and related review activity.

3. Audit tips for practices

   This section outlines general internal review steps practices can use when evaluating incident-to claims. It discusses checking schedules, claims, and documentation at a high level.

4. Established patient scenarios and staff guidance

   This section describes broad established-patient billing scenarios and how contractor guidance may be used for staff education. It also notes the potential for confusion between office and facility workflows.

5. Resources

   This section lists source references and contractor materials cited in the article.