Understanding Incident-To Compliance

Event Information
Product Format
Prerecorded Event
90 minutes
Product Description

Get a Better Understanding of the Rules Governing Incident-To Services


Most physicians use incident-to services at some time or other, yet face difficulties in navigating the “incident-to” rules—evident by latest Medicare audit settlements and recoveries. Lack of understanding incident-to rules can present pitfalls to unwary physicians and their staff, directly affecting payments and billing for the services rendered on behalf of groups, facilities and physicians.

It can also lead to government intrusion, overpayment demands, audits and false claim allegations. In few cases, there might not be any alternative to billing a service as incident-to, or the other options will result in less reimbursements. Medicare has very specific rules as to when you can use incident-to and how to bill under a supervising physician’s NPI.

In this session, our expert speaker Duane C. Abbey, Ph.D. will do an overview of the incident-to concept, discuss areas of applicability, and compliance concerns surrounding the concept.

In this audio conference, you’ll get answers to the following important questions:

  • Why does CMS frequently refer to incident-to services?
  • What does incident-to really mean?
  • How does incident-to relate to hospitals and physicians?
  • Is incident-to a compliance issue?
  • What are the rules and regulations concerning incident-to services?
  • How is it related to the 3-Day Payment Window?
  • How does incident-to relate to physician supervision requirements?
  • How does incident-to relate to the provider-based rule?
  • How is incident-to process used by physicians for billing?

Session Highlights:

  • Review and discuss the two different uses of the phrase, incident-to, as provided in the Social Security Act (SSA).
  • Understand hospital payment relative to incident-to physician services.
  • Familiarize yourself with hospital benefit categories under the SSA.
  • Understand how incident-to is a compliance issue in multiple situations.
  • Discuss incident-to physician services in the provider-based clinic setting.
  • Review how incident-to is involved in the 3-Day Payment Window.
  • Explore several case studies to illustrate the intricacies surrounding the incident-to concept.
  • Understanding Incident-To and The Social Security Act.
  • Incident-To billing for physicians
  • Incident-To services for hospitals
  • Associated impacts of the incident-to concept
  • Case studies

Who should attend?

All 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, and 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
More Events By The Speaker

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