Coding and Billing for Mid-Level Providers

Event Information
Product Format
Prerecorded Event
Presenter(s)
Barbara J. Cobuzzi, MBA, CPC, CENTC, COC, CPC-P, CPC-I, CPCO, AAPC Fellow
Length
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. Is your practice ready for an audit?

The Centers for Medicare & Medicaid Services (CMS) rules for coding and billing for clinicians are clear, but you need to know where to find these rules. Your state may have its own unique rules, and you need to understand those, too. Knowing your clinicians’ top compliance risks will go a long way toward helping you avoid penalties and sub-par audit results.

In this informative session, expert Barbara J. Cobuzzi will share must-know tips for any practice interested in improving its clinicians’ compliance with CMS and other payers’ rules for documentation, coding and billing.

Session Highlights

  • How and where to find Medicare’s rules for clinicians?
  • How Medicare addressed the changing supervision rules for NPPs?
  • What questions must the non Medicare payers be asked to determine what the practice needs to do in order to be compliant?
  • Policies and procedure recommendations consistent with Medicare and other payer rules
  • Risk assessment—What are your compliance risks when it comes to utilizing NPPs?
  • How to withstand an audit of documentation, coding and billing for NPPs?
  • Documentation requirements for evaluation and management services (E/M services)
  • Determining who has the ability to bill for services and when
  • The different insurance protocols regarding billing of E/M services
  • Medicare’s rules on shared visits
  • License requirements and 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 “incident to” rules of the CMS be applied to non CMS payers?
  • What if the non-Medicare payer does not credential or recognize the NPP’s NPI?
  • Time based codes involving NPPs
  • Care plan oversight
  • Modifiers for use with Medicare carriers
  • MD share a visit with a hospital employed NPP
  • Shared/split visit documentation
  • Medicaids and other commercial carriers
  • Examples and 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

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You can also order through:

1-866-458-2965

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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
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