Author Topic: ' incident-to-services'  (Read 1280 times)

bobbie

  • Newbie
  • *
  • Posts: 10
' incident-to-services'
« on: February 01, 2010, 05:40:58 PM »
Help wise ones! I know that medicare allows for "incident-to-services" to be billed under the right criteria. Do the other carriers like Aetna, Anthem Blue Cross, Blue Shield, United Behavioral, Value Options.....allow for it as well? I have a group practice (Mental Health) who has one psychiatrist and several interns that they intend to bill services under. I advised them not to do this as the therapist must be a licensed provider with an NPI number but they feel that they fit into the "incident to" option. I think I'll have to terminated with them, what do you think?

Pay_My_Claims

  • Guest
Re: ' incident-to-services'
« Reply #1 on: February 01, 2010, 07:06:14 PM »
I don't know about that, but have you called the other carriers???


bobbie

  • Newbie
  • *
  • Posts: 10
Re: ' incident-to-services'
« Reply #2 on: February 01, 2010, 07:46:24 PM »
I called Anthem but the rep asked me to spell it! She was clueless. I'm waiting for Provider Relations to call me back. I reviewed all the contracts and I sure don't see the term in any of them. I think the new administrator has misinformed the main doctor of the group.  ??? ???

Steve Verno CMBS, CEMCS

  • Full Member
  • ***
  • Posts: 119
Re: ' incident-to-services'
« Reply #3 on: February 02, 2010, 05:50:03 AM »
Incident to is for Medicare and it is strict with its rules.  A practice may have its own internal beliefs but it must abide by the rules established for incident to. 

Some commercial insurances may allow incident to and have their own rules, which may follow the same guideline as Medicare.  Cigna has a policy and it follows the Medicare rule.

We cant tell you what to do with a client.  You can advise what the rules contain, but it is up to the practice to follow the rules that are established. If they dont, then they answer to audits, sanctions, fines and refunds. 
I'l have a double chubby chuck, a mexicali chilibarb, and two cherry cokes
Left hand Blue, Right Leg Green
You got your peanut butter on my milk chocolate.
Dont cut the blue wire! 
I love spam.