Billing, Rendering and Supervisor

hajektl

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Our BCBS rep told us to bill a new NP with our main providers name for all 3 of them and add the SA modifier? The new nurse practitioner isn't contracted with them yet. This doesn't seem correct since it will look as if a MD saw the patient. Can some shed some light on this if you know where I can find the back up documentation that would be great.
 

CodingKing

True Blue
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Most payers will have a published policy about services under "incident to" guidelines. If the "incident to" guidelines are not met they cannot be billed under the MD name.

Some additional info that references Anthem where they can only bill under incident to until the NP/PA is issued their provider number. It also talks about how each payer is different:

http://medicaleconomics.modernmedic...incident-billing-clearing-confusion?page=full
 
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