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Webinar/Audio Conference FAQs

This session will address compliance concerns regarding mid-level provider billing patterns. The doctor has left the building. Now what? Can we still bill Incident-to? Understand why the OIG is looking at Incident-to services this year and get clarification on the guidelines and billing requirements. The rules and guidelines for Medicare and other third-party carriers can get confusing when billing for non-physicians practitioners. This session will help you better understand the rules and avoid possible fraudulent billing for your mid-level practitioners.

This Webinar will cover these topics:

• Differences in type of mid-level providers
• Why the RACs are scrutinizing practices that employ mid-level providers
• Incident to billing criteria, requirements and reimbursement issues
• "Scope of practice" for mid-level providers according to state law
• Differentiating between "scope of practice" and "scope of license"
• Examples of non-physician practitioners and auxiliary personnel
• Explanation of setting of services
• Incident-To FAQs
• Get concrete examples and answers your questions about billing in many types of situations.
• Get the guidance you need to ensure that the documentation supports your claims

"Incident to" services are specific to Medicare billing and have defined guidelines that must be followed. Medicaid carriers in most states follow the rules set by Medicare for billing of these types of services, but not always. Some of your other carriers may reimburse for non-physician practitioners differently. It is imperative that you review your participation agreement with every managed care company that you contract with.

About the Presenter

Linda D'Spain represents a number of medical groups as a leader, manager and practice growth specialist. She is an accomplished presenter with more than 20 years in practice management. She is a Board Certified Medical Practice Executive through the American College of Medical Practice Executives and is currently working toward her fellowship in Health Care Administration. She holds all four certifications through Practice Management Institute and conducts regular training for physicians and staff across the country.