Medical Billing Forum

Billing => Billing => Topic started by: integrativebiller on December 27, 2012, 01:59:48 PM

Title: Billing for Physician's Assistant
Post by: integrativebiller on December 27, 2012, 01:59:48 PM
Hi!
I bill for a doctor in southern CA; we're about to hire a PA to help the doc w/ physicals, urgent appointments, etc, though there's talk of having her see her own patients in the future.  I need a little billing help--we use Office Ally, but they can't give me specific enough info, nor have individual carriers been much help.  I do know a little about incident-to billing from Medicare, and I have learned that Anthem wants our PA to be listed as the rendering provider under our tax ID, but that's about it.  So here are some questions to start me out:
1. If we list the PA as rendering provider, would we be reimbursed at 100% or 85%?
2. What is the referring provider, and would we ever have the doc's name there?
3. Is incident-to ever used in other carriers besides Medicare?

I think that's a good start, any help would be appreciated, and if I've missed a big topic please let me know!
Thanks!!
Title: Re: Billing for Physician's Assistant
Post by: Michele on January 03, 2013, 10:11:24 AM
How much they are paid (85% or 100%) will depend on each carrier/plan.  As for the referring provider, that would only be used if the patient was referred to your office.  You wouldn't use the dr that the PA is working for.  I believe incident to billing is Medicare only.

Title: Re: Billing for Physician's Assistant
Post by: integrativebiller on January 04, 2013, 11:52:35 AM
How much they are paid (85% or 100%) will depend on each carrier/plan.  As for the referring provider, that would only be used if the patient was referred to your office.  You wouldn't use the dr that the PA is working for.  I believe incident to billing is Medicare only.

Thank you, Michele, this very helpful information.