Reimbursement guide for nurse practitioners to survive the storms in 2013!


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As a nurse practitioner there is enough on your plate already ! Reimbursements guide for nurse practitioners to survive the storms in 2013 ! For more info

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Reimbursement guide for nurse practitioners to survive the storms in 2013!

  1. 1. Presented byAngomark, MedicalBillingStar
  2. 2. Six Questions You Need To Ask Your Insurer• Health plans that allow billing with fewer restrictions than Medicare.• Unfortunately, this leaves you needing to regulate the policy of each health plan with which you contract.
  3. 3. 1.Do you credential non physician providers ?
  4. 4. 2. Do you include them in your provider listing and allow patients to select them as primary care providers?
  5. 5. 3. Do you require that submitted claims usethe NPPs name and provider number, or the physicians name and provider number?
  6. 6. 4. Do you require any specific level of supervision or protocol ?
  7. 7. 5.If we bill for the services of the NPP using the physicians provider number, and the patients usual physician is not in the office, should we bill under the usualphysicians name or the name of a physician who is in the office ?
  8. 8. 6. What is your reimbursement rate for NPP services ?
  9. 9. Know that you can insist on 100% reimbursements if
  10. 10. • The physician sees the patient and inductees the plan of care that the NPP is carrying out. For example, the physician sees a patient with hypertension and asks the patient to follow up with the NPP.• The physician remains involved in the patients care and brochures this involvement in the patients chart. For example, the physicians review of the NPPs note or discussions between the NPP and the physician may be documented, as well as intervallic face-to-face time between the physician and the patient.
  11. 11. • The NPP must be an employee of the physician or the group that employs the physician.• The patients physician must be in the office and directly available. Medicare has made it clear that you may not bill the NPP service under the physicians provider number unless the physician is in the suite of offices and immediately available to provide backup. Telephone availability is not sufficient.
  12. 12. • The service must be provided in the office. Incident-to services may not be billed in the emergency department, hospital or nursing home. Incident-to services are meant to cover usual and typical services provided in the office.• Unless the provider is a nurse practitioner, physician assistant, certified nurse midwife or clinical nurse specialist, the service can only be billed as 99211.
  13. 13. Thank You ! Your Queries on Nurse Practitioner Billing Services are most welcome Mail us info@medicalbillingstar.comVisit us