Question Provider being intimately involved in procedure with NP

Ericad12

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We have an NP in our office that performs excisions of both malignant and benign lesions - BCBS is stating that our Doctor has to be intimately involved in the procedure for the claim to be paid. Can you please advise on what "intimately involved" means in terms of what he needs to be doing. Does he have to perform the whole service? Can he just be involved in the treatment plan and closure? Any information is greatly appreciated!
 

thomas7331

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I have no idea what that means, nor what documentation would be necessary to prove that. Really BCBS should be the one answering that question for you though. BCBS has different plans and policies in every state, so without knowing which state is giving you this information, it's hard to advise further. But if they are making that a requirement, then they should be able to direct you to their written policy which would give you additional details.
 
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