The official rules for "incident to" billing apply ONLY to MediCARE (and perhaps your state's MedicAID if they follow Medicare to the letter).
We do not bill "incident to." Our PAs and NPs are credentialed with Medicare and Medicaid and bill services they provide under their own names/NPI numbers.
Our commercial carriers do not credential PAs and NPs. They ask that we submit services by these allied health professionals under the name/NPI of the supervising physician - which is what we do.
Our coding/billing software allows us to enter the charges under the actual provider (e.g. PA Smith), while sending the claim out under the supervising physician (e.g. Dr Jones). This way we have a clear understanding of who actually provided the service.
We have no problem getting paid - even when documentation is requested.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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