Online Training Course

Billing for Mid-Level Providers

Reduce your audit risk and ensure that billing procedures are compliant. Instructor will review documentation guidelines and provide examples and guidance on tough billing situations.

CEUs

3

Length

180 min

Price

$199


Mid-level provider claims are a common audit risk area. Review tough billing situations with examples and guidance on documentation needed to support claims. Learn when it is appropriate to bill under the provider initializing care or under the supervising providers and improve aptitude for cross-checking and code selection.

  • Incident to billing criteria, requirements and reimbursement considerations
  • Direct vs. indirect supervision by the physician/NPP
  • Level of education, scope of practice and other protocols of the NPP
  • State definition of scope of practice for mid-level providers
  • Differentiating between scope of practice and scope of license
  • Examples of non-physician practitioners and auxiliary personnel
  • Explanation of service settings such as unsupervised or off-site
  • Difference between Nurse Practitioner and Physician Assistant
  • Guidance on which national provider identifier (NPI) to bill claims under
  • Review documentation guidelines
  • Why CMS recovery auditors are scrutinizing practices that employ mid-level providers
  • Working with NPPs under independent contract agreement
  • Question and answer period to address participant questions

Aimee Wilcox

CPMA, CCS-P, CST, MA, MT


Aimee is the Director of Content for Find-A-Code, an online medical billing and information database. She is a medical coding, billing, and auditing author and educator with more than 30 years of clinical and administrative healthcare experience working in a variety of specialties, in both small and large organizations. She has authored and co-authored over 40 books on ICD-10-CM and reimbursement issues, as well as authoring a successful online medical coding course.

At Find-A-Code, Aimee writes and creates tools and resources that aid healthcare professionals to perform their jobs more efficiently and accurately. She also consults in coding, billing, auditing, and provider documentation issues, providing assistance in complying with insurance payer policies and protecting revenue. Her clinical background helps her communicate more effectively with providers on their documentation issues and patient care processes.

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