Billing and coding for mid-level provider seems simple at first but often poses a lot of pitfalls that many private practices, groups, and hospitals are unaware of until they undergo an audit and are levied a hefty fine. Many think the billings rules for nurse practitioners and physician assistants are the same from payer to payer but they are not. Understanding the nuances between the payers is key to obtain maximum reimbursement and remain compliant.
It is important to know when a mid-level provider should be billed incident to a supervising physician and when they should be billed under their own NPI number. Not only it is critical to know when this should be done but clinical and billing staff must be trained on the documentation requirements that each payer expects to support billing for services rendered by mid-level providers that are billed incident to a supervising physician. For instance, some payers require physical presence of the physician during the visit, with a signed attestation – other payers will accept a simple co-signature with proof the physician has had ongoing management of the patient throughout their tenure in the practice.
This webinar is designed to address all of these issues and many more – ensuring your practice, group, or facility are compliant. It will also give you tips on how to maximize reimbursement and guidance on clinical documentation.
- Understand nuances between payers in regards to billing for mid-level providers.
- Understand documentation requirements for services rendered by mid-level providers.
- Understand when it is appropriate, and not appropriate, to bill a mid-level provider incident to a supervising physician.
- Pointers on how to maximize reimbursement for services rendered by mid-level providers.
- Understand the pitfalls that make you a target for an audit on services provided by mid-level providers.
- Tips for surviving an audit should it occur.
- 2019 updates that affect coding and billing for services rendered by mid-level provider.
Areas Covered in the Session:
- Rules in regards to services rendered by mid-level providers
- What is a supervising physician and what role do they play in the process
- Clinical documentation requirements
- Insurance nuances
- Compliance pitfalls – what makes you a target
- What happens during audits and how to prepare
- How to respond to an audit finding
- Tips to maximize reimbursement for mid-level services
- 2019 updates in regards to mid-level services
- Physician Assistants
- Nurse Practitioners
- Medical Assistants
- Practice Manager
- Office Managers
- CDI Specialists
- Collection Staff
- Front Desk
About the Presenter:
Dreama Sloan-Kelly, MD, CCS has over 14 years of experience in the medical field. A graduate of Wellesley College and Tufts University School of Medicine she has an extensive background including clinical, billing, and coding. Dreama is President/CEO of Dr. Sloan-Kelly Consulting, LLC and speaks at various seminars and webinars, imparting her knowledge in an upbeat, matter of fact, manner. Her goal is get the pertinent information to the attendee, minimize the nonsense, and make sure everyone has fun at the same time. Dreama works with practices one on one, through coding consulting. She offers in-services seminars that can be held on or off-site. Dreama has learned in most seminars you spend a whole day only getting 20% of what you need, and 80% you leave – she has made it her goal to carve out the 20% that you need and giving you the take home message that will help you and your practice.
You will receive an email with login information and handouts (presentation slides) that you can print and share to all participants at your location.
Operating System: Windows any version preferably above Windows Vista & Mac any version above OS X 10.6
Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly
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