Wiki Incident to billing

[shanamarie]

Hello, I have a couple of questions regarding incident to billing that I'm hoping someone can help with. It's my understanding that the claim only has the supervising providers name/credential, is that correct? Is it a requirement for the supervising providers name or signature to be on the chart note? If not how do you prove to insurance who the supervising provider is?

I appreciate any help with this! I'm just reviewing the CMS manual on this now.

 

[csperoni]

For the incident-to requirements, the supervising physician's name/signature do not need to be on the chart note. My understanding is depending on credential, some states require supervising physician to sign (regardless of incident-to). There are also some employers that may have this requirement.
In an audit situation, you might need to provide items like the provider's schedules to prove the on-site requirement.
Just make sure you are meeting all the incident-to requirements. From my experience, the most difficult for PA/NP seems to be the following an established plan of care portion. So medication adjustments, additional tests ordered, or a new problem all must be billed under the PA/NP.
Also don't forget this is a CMS rule, and private insurance carrier rules may differ.

 

[trarut]

Everything Christine said above. We have an internal requirement that the NPs document their supervising physician in their incident-to visit notes.