Medicare Compliance & Reimbursement

100 percent pay is possible if NPP follows physician's plan of care. If you do not consider billing "incident to" the physician when a qualified nonphysician practitioner (NPP) performs services for Medicare patients, you are letting deserved reimbursement fly out the door. Bottom line: When you bill incident-to, you garner 15 percent more per service than if you bill under the NPP's national provider identifier (NPI). Incident-to coding does have some strict rules, though. To ensure that all your incident-to claims are on target, answer these questions before billing. 1. Has The Internist EstablishedA Plan of Care? To qualify for incident-to billing, the internist must see the Medicare patient during the initial visit and establish a clear plan of care, reported Sharlene Scott, CPC, CPC-H, CCS-P, CCP-P, PMCC, during a presentation at The Coding Institute's multispecialty conference in Orlando, Fla. (www.codinginstitute.com). If the NPP is treating a new problem for the [...]