Wiki NP billing while pending to be credentialed

[telemind]

I have heard form one of our local doctors that we can bill services rendered by our Nurse Practitioner while still pending to be credentialed with our local insurances. It will be billing our Dr as the supervising provider and the Nurse Practitioner as the rendering provider while pending to be credentialed? Is this correct information? Can anyone possible attest to this from previous experience.

Thank you in advance!

 

[suzyqbiker]

As long as the NP notes in her dictation that she consulted with the provider for coordination of care, you can bill the commercial insurances. Anything for Medicare or Medicaid should be held, they will back date the credentialing.

 

[thomas7331]

It is not sufficient just to consult with the supervising provider to be able to bill under the physician's credentials - the visits must meet all of the 'incident to' requirements (e.g. the NP may only see established patients and treat established problems, the MD must be present in the office at the time, etc.) in order for the NP to be able bill their services under the supervising provider. There are many good articles published about the requirements for 'incident to' billing - I'd recommend reviewing these requirements before scheduling and billing. Commercial payers may have their own guidelines different from CMS for billing under a supervising provider, so I would recommend reviewing your payer policies as well.