Wiki Incident to billing to Commercial carriers

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lisa3005DUPLICATE

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Does anyone know where I can find the commercial carriers' rules for incident to billing? I've tried searching ALL of the commercial carrier's websites and the only payer that has information is BCBS/Anthem.

Does anyone have suggestions as to where to get this information? My practice manager wants documentation for the commercial carriers.

Thanks for your help.
 
They don't all publish their 'Incident To" guidelines. Even if they do publish them, they may be hard to locate online. You may have to call them individually.
 
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We also have found that only Aetna/Coventry use incident to billing, and, like Medicare, they will reduce payment to 85% when you have to bill under the mid-level.

According to the information I have gathered, Cigna, GHI, and Humana want you to always bill under the doctor, while BCBS Florida, Tricare, and UHC want you to always bill under the mid-level (but they pay at 100%).
 
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