Advanced Search

Medicare Compliance & Reimbursement

Incident-to Billing:

Shore Up You Incident-to Claims or Face OIG Scrutiny This Year

Published on Tue Jan 31, 2012

Ensure your visit meets 4 criteria before filing an incident-to claim. If you don't know how to correctly bill the services the non-physician practitioners (NPPs) in your office perform, it could cost you more than the 15 percent difference in reimbursement rates. Here's why: As part of its 2012 Work Plan, released last October, the HHS Office of Inspector General (OIG) plans to scrutinize incident-to services. Your best bet for avoiding OIG scrutiny is not to bill incident-to unless you're sure you've met the requirements. Here's what you need to know to keep you practice off the OIG hot list. Learn What Incident-to Means As most practices are aware, under incident-to rules, qualified NPPs can treat certain patients and still bill the visit under the physician's National Provider Identifier (NPI), bringing in 100 percent of the assigned fee. How it works: When an NPP provides a service to a Medicare [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Medicare Compliance & Reimbursement

View All