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Medicare is a complex payer, with complex guidelines on collaborative care. Understanding what collaborative care means from a billing and documentation perspective is vital to ensure you are receiving appropriate reimbursement for the services of non-physician practitioners and clinical staff. In addition, CPT® 2018 includes new information as it relates to nurse visits for anticoagulation management – will 99211 become obsolete? In this webinar, you will learn the differences between split-shared and incident-to billing, and where these concepts are applicable.

Why is this topic important?
Medicare has complex guidelines as it relates to the ways a provider or a practice can bill for the services of multiple individuals involved at one time in a patient’s care. It can be done, but the rules for each situation vary significantly. It is important to understand the exact documentation requirements for each scenario to optimize reimbursement without needing to increase provider time or effort.

Who would benefit from this topic?
Those individuals involved in the documentation and billing of providers in group practices, who provide services in hospital settings, provider-based clinics, free-standing clinics, and provide nurse visits.

How would this benefit the individual and/or their company?
This will allow the audience members to bill compliantly and optimally for the services of various providers, especially in circumstances where it is possible to receive 100% of the Medicare Physician Fee Schedule for the work of non-physician practitioners.

What information or new skills will the attendee take away from this webinar?
The attendee will learn the differences between split-shared billing and incident-to billing, and in which places of services they are applicable, as well as how to bill for nurse services according to newly available CPT® codes.

Why are you the expert on this topic?
Lara is CEMC certified and holds AAPC Fellow. Her current and two prior jobs have included audit and education of providers as it relates to complex Medicare billing and coding concepts, such as split-shared and incident-to documentation and billing. She was the primary auditor and educator for a group of critical care physicians and surgeons in a large hospital system who billed using these concepts on a regular basis. Their understanding was vague at best in the beginning, and after working with them they were able to consistently pass their internal audits and, as a result, reduce their risk of inaccurate claim submission and reimbursement to Medicare and other payers.

Agenda

• Incident-to
  -Nurse Visits
• Split-Shared
• Teaching Physicians
  -Medical Students
  -Primary Care Exception
  -Modifiers GC & GE
• Scribes

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