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Wiki Billing Provider for MA claims

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PhyllisT

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Although Medicare Advantage claims are reimbursed PMPM and not Dollar-for-Dollar like straight Medicare FFS if an APC ( Advanced Practice Clinician/Non-Physician Practitioner)has an NPI# and credentialed with Medicare and not billing Incident-to should thery be identified on the CMS Claim/837 as the rendering/billing provider.
Thanks,
Phyllis Thomas, CPC-I, CRC
thomas.phyllis@scrippshealth.org
 
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