Coding and Billing for Non-Physician Practitioners

Event Information
Product Format
Prerecorded Event
Conference Date
Thu, Oct 25, 2012
90 Minutes
Product Description

Learn How Non-Physician Practitioners Are Reimbursed For Services Under Medicare and Other Private Payers!

Join Duane Abbey for this 90 minute audio conference where he will review the range and type of non-physician practitioners that are utilized by physicians, clinics and hospitals. You will learn how NPPs are reimbursed for services under Medicare and other private third-party payers, understand proper coding conventions and utilization of modifiers for NPPs, understand the difference between ‘freestanding’ situations and ‘provider-based’ situations, get a review on the interplay between the MPFS and APCs for non-physician reimbursement in different settings and more.  

Dr. Abbey will work through case studies illustrating the coding, billing and claims filing process and differences in payment.

You’ll get answers to these questions and more:

  • Who are all these non-physician practitioners (NPPs)?
  • Can non-physician practitioners bill separately to the Medicare program?
  • Do non-physician practitioners have to work incident-to physicians?
  • Where do I find out about state scope-of-practice laws?
  • How much do practitioners get paid under the Medicare Physician Fee Schedule?
  • What kind of requirements are there for NPPs and how do they relate to physicians?
  • Are NPPs involved in provider-based clinics and Rural Health Centers (RHCs)?
  • Are there special compliance issues that affect NPPs?
  • Can NPPs establish their own independent practices?

Webinar Agenda:  

  • Non-Physician Practitioner Overview
    • Types of NPPs
    • Medicare versus State Law Requirements
    • Utilization of NPPs
    • Reimbursement Issues for NPPs
    • Compliance Issues for NPPs
  • Professional versus Technical Component Payment
    • RBRVS Review
  • Relative Values
  • Place of Service Differential
  • Examples – Reduced Payment for NPPs
    • APC Review
    • Freestanding versus Provider-Based Status
    • Private Practice for NPPs
    • Medicare Enrollment
  • Non-Physician Practitioners – Compliance
    • The ‘Incident-To’ Concept
  • Freestanding Situation
  • Provider-Based Situation
    • Place of Service (POS) Considerations
    • Collaborative Agreements and Other Requirements
    • Joint E/M Services with Physicians
  • Examples and Case Studies
    • Nurse Practitioner in Medical Practice
    • Physician’s Assistant in Provider-Based Clinic
    • Clinical Nurse Specialist in Hospital Setting
    • Nurse Practitioner at Urgent Care Center
  • Sources for Further Information

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker. 

Who should attend? Coding Personnel, Billing and Claims Transaction Personnel, Chargemaster Coordinators, Clinic Managers, Financial Analysts, Compliance Personnel, Nurse Practitioners, Physician’s Assistants, Clinical Nurse Specialist, Speech-Language Pathologists, Nurse Midwives, Physicians 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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