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Home > Audio Learning Center > Mastering NPP Billing Challenges

Mastering NPP Billing Challenges

Date:Wednesday, June 2, 2021
Time:12 noon to 1:00 p.m. Central Time

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Presented by: Jan Hailey, CMC, CMIS, CMOM, CMCO

Webinar/Audio Conference FAQs

Back by popular demand – join us for this rebroadcast of a PMI favorite.

Non Physician Provider (NPP) claims are a common audit risk area. Proper billing for non-physician providers requires a thorough comprehension of a variety of requirements including scope of practice, licensing, incident-to and supervision/collaboration rules. Gain answers to tough billing situations.

The instructor will offer concrete examples and clarification the documentation required to support non physician provider claims. Take part in this detailed review of the physician supervisions rules for proper incident-to billing. Receive an explanation of documentation guidelines and episodes of care. Learn when it is appropriate to bill under the provider initializing care, and under the supervising providers. Ensure compliant billing procedures and reduce audit risk.


  • Incident to billing criteria, requirements and reimbursement considerations
  • Direct vs. indirect supervision
  • Level of education, scope of practice and other protocols of the NPP
  • Differentiating between scope of practice and scope of licensing requirements
  • Examples of non-physician practitioners and auxiliary personnel
  • Explanation of service settings such as unsupervised or off-site
  • Differences between various provider types
  • Guidance on which NPI to bill claims under
  • Working with NPPs under independent contract agreement

Continuing Education Units (CEUs)

PMI CEU APPROVED Earn 1 PMI CEUs for attendance at this program. Practice Management Institute grants CEUs for its certified professionals based on total number of instructional hours (1 CEU per hour of classroom instruction). CEUs may be applied to annual recertification requirements, as directed in the certification renewal requirements for your credential(s).

If you are seeking CEU credits for other certifications or organizations, please contact your organization for pre-approval and credit guidelines. A certificate of attendance will be provided.

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About the Presenter

Jan Hailey has more than 20 years of experience in healthcare with proficiency in administration, coding, and billing roles. She joined Saint Joseph Physician Network in South Bend, Indiana as the Director of Quality in November 2015 to lead ambulatory quality initiatives and performance improvement. She leads a comprehensive interdisciplinary team across the health system and works closely with providers, management, and payers to develop strategies on process improvement, gap closures, and patient experience.

Jan also developed a documentation improvement program and is currently implementing an education program for Hierarchical Condition Category (HCC) coding in order to improve risk scores. She holds four professional certifications in office management, coding, and compliance. She is a member of WPS Medicare’s Provider Outreach and Advisory Group, Indiana Association for Healthcare Quality.

Jan has a passion for teaching and facilitates educational programs nationwide. Prior to joining Saint Joseph, Jan was the Director of Quality, Coding and Compliance for one of the largest health systems in Northern Indiana.

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