Coding and Billing for Mid-Level Providers

Event Information
Product Format
Prerecorded Event
Barbara J. Cobuzzi, MBA, CPC, COC , CPC-P, CPC-I , CPCO, CENTC, AAPC Approved ICD-10-CM Instructor
60 minutes
Product Description

How to Understand Medicare Rules and Avoid Fraudulent Billing for Your Clinicians

Correctly documenting, coding and billing for the services your clinicians provide patients is an area of perennial concern for federal health care regulators such as the Centers for Medicare & Medicaid Services and the Office of Inspector General. Is your practice ready for an audit?

Medicare’s rules for coding and billing for clinicians are clear, but you need to know where to find these rules. And just because you know Medicare’s rules does that mean you know how to code and bill for non-Medicare payers. You also need to understand if your state’s Medicaid program follows Medicare rules, or if it has its own unique rules. Knowing your clinicians’ top compliance risks will go a long way toward helping you avoid penalties and sub-par audit results.

Join nationally-known speaker and presenter Barbara Cobuzzi for a 60-minute information-packed session to gain a practical understanding of Medicare rules for coding and billing for clinicians, including mid-level providers.

Session Highlights

  • How and where to find Medìcare’s rules for Mid-Level providers
  • How Medícare addressed the changing supervision rules for Mid-Level providers in the proposed rule for 2016 fee schedule
  • What questions to ask non Medìcare payers to determine what the practice needs to do in order to be compliant?
  • Policies and procedure recommendations consistent with Medìcare and other payer rules
  • Risk assessment - What are your compliance risks when it comes to utilizing Mid-Level providers?
  • How to withstand an audit of documentation, coding and billing for Mid-level providers
  • Documentation requirements for evaluation and management services (E/M services)
  • Determining who has the ability to bill for services and when
  • The different ìnsurance protocols regarding billing of E/M services
  • Medìcare’s rules on shared visits
  • License requirements & scope of practice
  • What are your state’s rules?
  • Different types of supervision - Direct supervision, personal supervision, general/indirect supervision
  • Billing procedures for CRNPs and PAs in your practice
  • Incident to Services and “incident to” criteria per CMS
  • Can CMS’s “incident to” rules be applied to non CMS payers?
  • What if the non-Medìcare Payer does not credential or recognize the NPP’s NPI?
  • Time Based Codes involving NPPs
  • Care Plan Oversight
  • Modifiers for use with Medìcare Carriers
  • MD share a vìsit with a hospital employed NPP
  • Shared/Split Visìt Documentation
  • Medicaids and other Commercial Carriers
  • Examples & Questions

Who Should Attend

  • Physicians
  • Mid-level providers
  • Office managers and administrators
  • Coding managers and coders
  • Billing managers and billers

Order Below or Call 1-866-458-2965 Today

We Also Recommend
Audit Challenges with Electronic He...

- Jill M. Young, CPC, CEDC, CIMC

Updates on Fraud Investigations aga...

- Thomas J. Force, Esq.

ACA Repeals: Impact and Challenges ...

- Dr. Dreama Sloan-Kelly, MD, CCS

Diagnosis Coding, Billing and Docum...

- Jill M. Young, CPC, CEDC, CIMC

Observation Documentation for Prope...

- Duane C. Abbey, Ph.D.

Order Form

(Select the format below)

You can also order through:



About Our Speaker

Barbara J. Cobuzzi - Healthcare Compliance Training Expert

Barbara J. Cobuzzi is Vice President of Stark Coding and Consulting LLC in Shrewsbury, NJ. She holds a B.S. in industrial engineering from Rensselaer Polytechnic Institute and an M.B.A. from New York University. She holds certifications from the American Academy of Professional Coders (AAPC) as a CPC (certified physician coder), COC (certified hospital outpatient coder), CPC-P (certified payer coder) CPC-I (certified coding instructor) and CPCO (certified professional compliance officer). She...   More Info
More Events By The Speaker

Why AudioEducator?
  • Save money on travel.
  • Meet your specific training needs.
  • Keep learning after the event.
  • Save time training your whole staff.