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Billing for ACPs is really the same regardless of specialty. Is there something specific you had a question about?
 
You should 100% credential your ACPs for any carrier that will. If I recall correctly, only 1 carrier in my area does not. Here is why it is important to credential your ACPs.
1) Not all carriers follow incident-to. Incident-to is a Medicare guideline that some commercial carriers follow, and some do not. The ones that do not may require all services by your ACP to be billed under your ACP.
2) Even for carriers that do follow incident-to, not every visit meets ALL the requirements of incident-to. Suppose on Tuesdays Dr. B is usually onsite, but today Dr. B is on vacation. If your ACP does not have a physician onsite in your suite, it cannot possibly meet incident-to. Additionally, it limits the work that your ACP can perform if you are ONLY billing incident-to. Say your GERD patient is coming in for a follow up with your ACP. During the visit, patient mentions new onset constipation. Unless you are then interrupting the ACP visit and having the physician see the patient, the ACP treating the new problem cannot be incident-to.
Credentialing your ACPs allows you to bill for all of the services they provide. Some may be incident-to (if carrier follows AND it meets ALL requirements). Others will be billed under the ACP.
For the practices that my team codes for, 2 almost never bill incident-to as the physician is not onsite when ACPs have appointments. All ACP services are billed under the ACP. The other practice bills incident-to only when appropriate.
 
csperoni said:
You should 100% credential your ACPs for any carrier that will. If I recall correctly, only 1 carrier in my area does not. Here is why it is important to credential your ACPs.
1) Not all carriers follow incident-to. Incident-to is a Medicare guideline that some commercial carriers follow, and some do not. The ones that do not may require all services by your ACP to be billed under your ACP.
2) Even for carriers that do follow incident-to, not every visit meets ALL the requirements of incident-to. Suppose on Tuesdays Dr. B is usually onsite, but today Dr. B is on vacation. If your ACP does not have a physician onsite in your suite, it cannot possibly meet incident-to. Additionally, it limits the work that your ACP can perform if you are ONLY billing incident-to. Say your GERD patient is coming in for a follow up with your ACP. During the visit, patient mentions new onset constipation. Unless you are then interrupting the ACP visit and having the physician see the patient, the ACP treating the new problem cannot be incident-to.
Credentialing your ACPs allows you to bill for all of the services they provide. Some may be incident-to (if carrier follows AND it meets ALL requirements). Others will be billed under the ACP.
For the practices that my team codes for, 2 almost never bill incident-to as the physician is not onsite when ACPs have appointments. All ACP services are billed under the ACP. The other practice bills incident-to only when appropriate.
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I agree with you 100 %!! Very kind of you, thank you!! I will definitely share with the office.
 
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