NP in Credentialing Process

OmegaPM

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Can anyone give me some advice on if we are in compliance by allowing our NP who is in the process of being credentialed(apps already submitted) to see the patients on her own without the provider going in the rooms with her but who is readily available to answer any questions she may have, provider at the end of the day reads over her chart notes and signs off himself and then its billed as incident-to. We want to make sure that we are staying in compliance and doing everything by the books, any advice?
 

mitchellde

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Can anyone give me some advice on if we are in compliance by allowing our NP who is in the process of being credentialed(apps already submitted) to see the patients on her own without the provider going in the rooms with her but who is readily available to answer any questions she may have, provider at the end of the day reads over her chart notes and signs off himself and then its billed as incident-to. We want to make sure that we are staying in compliance and doing everything by the books, any advice?
To qualify to be billed as an incident to encounter then the incident to definition
The patient must an established patient present with a problem previously diagnosed by the provider, following a plan of care laid out in the previous note by the original provider and the provider must be in the office suite area while the patient is being seen.
Meaning it cannot be incident to if
This is a new patient
Established patient with a new problem
Established patient with and establish problem that the NP feels needs a medication changed or differs test run, or any patient while the provider is not in the office area.
 

OmegaPM

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To qualify to be billed as an incident to encounter then the incident to definition
The patient must an established patient present with a problem previously diagnosed by the provider, following a plan of care laid out in the previous note by the original provider and the provider must be in the office suite area while the patient is being seen.
Meaning it cannot be incident to if
This is a new patient
Established patient with a new problem
Established patient with and establish problem that the NP feels needs a medication changed or differs test run, or any patient while the provider is not in the office area.

To clarify the NP would not be seeing ANY NEW patients, NOR any patients with ANY NEW problems or issues, she would only be seeing well established patients while the physician is readily available should she have any questions. We want to make sure we are being 100% compliant in this process.
 
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