Case Studies to Reduce Your Compliance Risks with Non Physician Practitioners

Event Information
Product Format
Prerecorded Event
Elin Baklid-Kunz, MBA, CHC, CPC, CPMA, CCS
60 minutes
Product Description

Learn How to Reduce Risks of Fraud and Denials When Working with Non-Physician Practitioners

Non Physician Practitioners (NPPs) are playing an important role in every physician practice; however, non-compliant billing puts the practice of physicians at risk for fraud and denials. Many physicians are unaware of it.

This informative session by our expert speaker, Elin Baklid-Kunz, MBA, CHC, CPC, CPMA, CCS , will discuss how to avoid the risks of reduced payments; dealing with increased government scrutiny; and handling compliance issues. You’ll also understand Medicare’s requirements for incident-to and split/shared services. Plus, you’ll get handouts including self-audit checklists for shared visits and incident-to services.

Session Highlights:

  • Incident-to Supervising physician clarified in 2016 Medicare Physician Fee Schedule
  • Medicare’s Shared/split visits vs to “Incident-to”
  • Documentation and Billing Requirements
  • Audit Tips & Case Studies
  • Education tools to improve compliance

Session Agenda:

  • 2016 Medicare Incident-to Updates & Focus on NPPs
    • MPFS CY2016: Incident-to changes
    • 2009 OIG report: prevalence & qualifications of NPPs
    • 2013 OIG: error rate for Incident-to services performed by non physician
    • CMS CERT findings: Split/Shared/E/M services
    • Physicians duty to know: Certification Claim Form & Enrollment
    • CMS-1500 claim Form: Incident-to certification
    • OIG recent example Incident-to: false and fraudulent claim
  • NPP Risk Areas & Audit Consideration
    • Defining NPPs with examples
    • CMS booklet for APRNs & PAs
    • Auxiliary Staff
    • NPPs Services
    • Billing options for NPPs
    • NPP risk areas
    • Incident-to risk areas
    • Special audit considerations
    • Reviewing sources for audit concepts
  • Incident-to services
    • Physician involvement
    • Incident-to documentation
    • Billing Options: established patient & new problems
    • New or established problem Biopsy?
    • New or established problem? suspected Basal Cell
  • Split/Shared E/M Visits
    • Medicare’s Split Shared E/M visit defined
    • Split/Shared E/M Visit Basic Requirements
    • Examples Split/Shared E/M visit
    • Split/Shared E/M Visits Applicable E/M Codes
    • Split/Shared E/M Visits; Do Not Apply To?
    • Documentation Split/Shared E/M Visit
    • Examples of Unacceptable Documentation
    • Scribing?
    • Consider This Example: Split/Shared E/M Visit?
    • Private Payer Differences
    • Supervision of Diagnostic Tests
    • FAQs

Who should attend?

  • Coding professionals
  • Billing specialist
  • Practice managers
  • Him directors
  • Compliance officers
  • Case managers
  • Physicians

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

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About Our Speaker

Elin Baklid Kunz - Medical Billing Coding Expert


Kunz is a national speaker and published author on topics related to medical practice compliance, coding, reimbursement, chart audits and federal regulations. Her twenty years of healthcare experience includes six years as Director of Physician Services for a large health system, seven years in corporate finance and four years in compliance. She presents workshops for the American Academy of Professional Coders and delivers keynote presentations for Eli Research...   More Info
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