Identify Non-Physician Practitioners and how Hospitals and Physicians can effectively utilize them.
Join expert speaker Duane C. Abbey, Ph.D., in this 90-minute conference to get answers to questions such as:
- Who are all these non-physician practitioners (NPPs)?
- Is it possible for non-physician practitioners to bill separately to Medicare programs?
- Do non-physician practitioners have to work incident-to physicians?
- What are these joint/shared visits?
- Where do I find out about state scope-of-practice laws?
- How much payment do practitioners get paid under the Medicare Physician Fee Schedule?
- What requirements do NPPs have and how do they relate to physicians?
- NPPs involvement in provider-based clinics and Rural Health Centers (RHCs)?
- Can special compliance issues affect NPPs?
- How can NPPs relate to Medicare physician supervision rules?
- Is it possible for NPPs to start their own independent practices?
The objectives of the session are:
- To review the range and type of non-physician practitioners that are utilized by clinics, physicians and hospitals.
- To appreciate how non-physician practitioners are reimbursed for services under Medicare and other private third-party payers.
- To understand proper coding conventions and utilization of modifiers for non-physician practitioners.
- To understand the difference between ‘freestanding’ situations and ‘provider-based’ situations.
- To review the interplay between the MPFS and APCs for non-physician reimbursement in different settings.
- To appreciate the concept of ‘incident-to’ and the differences in interpretation between physician/clinic situations and hospital situations.
- To review the physician supervision requirements under Medicare for NPPs.
- To understand the proper use of shared/joint visits.
- To work through several case studies that illustrate the coding, billing and claims process and differences during payment.
- To review various compliance issues which are important, that includes the Place of Service (POS) and surround the use of NPPs.
- 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
- Shared/Joint E/M Services with Physicians
- Physician Supervision Requirements
- Medicare Physician Fee Schedule
- Medicare Physician Payment
- Examples and Case Studies
- Nurse Practitioner in Medical Practice
- Physician Assistant in Provider-Based Clinic
- Clinical Nurse Specialist in Hospital Setting
- Nurse Practitioner at Urgent Care Center
- Sources for Further Information
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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