Billing for Non-Physician Practitioners
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| Instructor: | Jan Hailey, CMC, CMIS, CMOM, CMCO |
| Schedule: |
Three instructor-led, 60-minute live online training sessions: Thursdays, July 16, 23 and 30; 12 noon – 1:00 pm Central (10 a.m. Pacific, 1 p.m. Eastern).
NOTE: Live session attendance is optional. See the materials section below for more information. Sessions are recorded and available in PMI’s Online Training Center 2-4 days after the last recording date. Registrants receive access to the session recordings and digital course manual for 6 months. |
| Online Course Fee: | $199 per person* |
| Target Audience: | This class is ideal for billing and claims processors, physicians, consultants and anyone seeking solutions and for claim rejections and denials. |
| Materials: | Registration includes a digital course manual |
| CEUs: |
PMI certified professionals earn 3 CEUs, emailed with certificate of completion |
*This Online Course is not included as part of the Total Access webinar subscription package.
Non-Physician Provider (NPP) claims are a common audit risk area. Certified PAs and NPPs may provide covered services to Medicare beneficiaries in accordance with their state scope of practice under state law and corresponding supervision/collaboration requirements.
In this multi-session live learning event, practice reimbursement professionals will learn compliant billing procedures to reduce audit risk. Get clarification on requirements and tough billing situations.
- Detailed review of the "physician supervisions rule" for proper incident-to billing
- Explanation of documentation guidelines for incident-to services and episodes of care
- When it is appropriate to bill under the provider initializing care or under the supervising providers
- Differentiating between scope of practice and scope of licensing requirements
- Level of education, scope of practice and other protocols of the NPP
- Examples of non-physician practitioners and auxiliary personnel
- Examples of direct vs. indirect supervision by the physician/NPP
- Working with NPPs under an independent contract agreement
- 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
Continuing Education Units (CEUs)
Earn 3 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 located in Mishawaka, IN as the Director of Quality in November 2015. In 2019, her role transitioned into Director of Care Management with Select Health Network, an entity of Saint Joseph Health System. This transition allowed for her expertise to expand beyond the physician network to lead a comprehensive interdisciplinary team across the health system and work closely with providers, management, staff, community 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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