Physician Supervision & Incident-To Compliance

Event Information
Product Format
Prerecorded Event
90 minutes
Product Description

Get All You Need to Know on Physician Supervision and Incident-To Compliance

The specific requirements for physician supervision can confuse many healthcare members. Several questions come to mind, including how CMS has changed the supervision requirements over the years and why it is such a big issue. Other questions that may cause confusion include how to satisfy the supervisory requirements for mid-level practitioners and affirmative steps that hospitals must take to ensure compliance.

To find answers to these and many other confusing questions, join this informative session by expert Duane Abbey, Ph.D., and get practical insights on physician supervision and incident-to compliance. Duane will also discuss topics such as establishing provider-based clinics, understanding the provider-based rule, conducting provider-based audits, and the 3-day payment window.

Session Highlights

  • What are CMS’ policies on incident-to services?
  • What exactly is meant by “incident-to”?
  • Does incident-to apply to physician services in hospitals?
  • Does incident-to have anything to do with physician supervision?
  • Is incident-to a compliance issue?
  • What are the rules and regulations surrounding incident-to services?
  • Are there differences between physician clinics and hospitals relative to physician supervision?
  • How does this relate to the 3-Day Payment Window?
  • How do physician supervision and incident-to relate to the provider-based rule?
  • How do physicians use the incident-to process for billing?
  • How does the Social Security Act use the phrase incident-to?
  • For physician supervision and incident-to, are there compliance implications?

Session Objectives:

This session will help you understand:

  • The two different uses of the phrase, incident-to, as provided in the Social Security Act (SSA)
  • The incident-to billing requirement for physicians
  • The hospital payment relative to incident-to physician services
  • Physician supervision for both physicians and hospitals
  • Hospital benefit categories under the SSA
  • How incident-to is a compliance issue in multiple situations
  • How the incident-to concept applies to recently changed physician supervision requirements
  • The incident-to physician services in the provider-based clinic setting
  • How incident-to is involved in special situations such as the 3-day payment window, RHCs and telemedicine
  • How the rules for supervision have morphed over time
  • Several case studies to illustrate the intricacies surrounding the incident-to concept

Session Agenda:

  • Introduction
    • Overview of the Incident-To Concept
    • Areas of Applicability of Incident-To Services
    • Compliance Concerns Surrounding the Incident-To Concept
    • Physician Supervision Requirements
  • Incident-To and The Social Security Act
    • Physician Payment Through Incident-To Services
    • Hospital Payment Through Incident-To Services
    • Self-Administrable Drugs
    • Understanding the Two Different Uses of the Phrase Incident-To
    • Hospital Services Benefit Categories
  • Incident-To Billing for Physicians
    • Physician Billing For Subordinate Staff Services
    • Presumptive Freestanding Clinic
    • Specific Requirements for Physicians
    • Physician Supervision Requirements
    • Special Concerns for Non-Physician Practitioners
  • Incident-To Services for Hospitals
    • Hospital Payment For All Services Incident-To Physicians
    • Presumptive Provider-Based Setting
    • Physician Supervision Rules
    • Specific Impacts for Hospitals
  • Physician Supervision
    • Special Requirements for Freestanding Clinics
    • Special Requirements for Hospitals
    • Documenting Physician Supervision
  • Associated Impacts of the Incident-To Concept
    • Provider-Based Rule
    • 3-Day Payment Window
    • RHCs
    • Telemedicine
  • Case Studies

Who should attend

  • Personnel involved with compliance, coding, billing and reimbursement
  • Financial analysts
  • Health information management personnel
  • Financial personnel
  • Patient financial services personnel
  • Chargemaster coordinators
  • Provider-based clinic and/or clinical operations personnel
  • Physicians and practitioners
  • Other interested personnel

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About Our Speaker

Duane Abbey Hospital Coding & Compliance Expert

 Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrolment and other financially related concerns of organizations....   More Info
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