Incident-To Billing & Auditing: Ensuring Compliance and Care

E-brief

In this eBrief, Lori Cox, MBA, CPC, CPMA, CPC-I, CEMC, CGSC, CHONC, and Director of Client Engagement for AAPC Audit Services, explores key elements for compliance with CMS incident-to requirements, ensuring accurate billing and optimal patient care. She discusses APP qualifications, exceptions to supervision requirements, and the significance of an established plan of care. Read it now to: 

  • Dive into systematic auditing steps for compliance assessment. 

  • Discover the importance of thorough documentation of supervision and plan of care. 

  • Address billing and coding accuracy to enhance reimbursement. 

  • Understand strategies for addressing audit findings and ensuring future compliance. 

  • Explore alternatives, like billing directly under the APP, for major issues. 

About the author

Lori Cox

Lori Cox has over 25 years of experience working in the business side of healthcare. She began her career in patient accounts and then moved into billing and coding for a multispecialty clinic. She was eventually promoted to billing supervisor and then to compliance officer, where she wrote, maintained, and trained employees and providers on fraud and abuse. Currently, Cox works for AAPC Services as Director of Client Engagement, performing audits and education for clients across the U.S. She has spoken at HEALTHCON and regional conferences and has traveled the country educating coders and physicians on complex coding topics such as hem/onc and E/M guidelines. Cox is the past member relations officer for AAPC’s National Advisory Board.

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