Incident to billing permits nonphysician practitioners to bill certain services using the physician’s CMS-issued unique 10-digit identification number, known as a national provider identifier. But Ms. Derricks notes that unmet incident to billing requirements can lead to claim denials for reasons such as services being billed for a new patient, or services being billed for a new issue with an established patient.
Her strategies for avoiding these denials are:
1. Ensure that a new patient’s first appointment is with a physician who can initiate a care plan.
2. Ensure an established patient with a new issue discusses the new issue with the supervising physician and that the physician initiates a care plan for the new issue.
3. Use the nonphysician provider’s national provider identification number, if a physician is not available to assess an established patient’s new problem and the nonphysician provider is credentialed with the insurer.
More articles on healthcare finance:
Washington health system on path out of bankruptcy after changing billing companies
Hospital chargemaster management: 4 tips for improvement
California firm seeks to reopen bidding for Hahnemann residency slots with $60M offer
