Author Topic: APN BILLING  (Read 3427 times)

srob48

  • Newbie
  • *
  • Posts: 12
APN BILLING
« on: March 19, 2012, 01:04:15 PM »
We have an APN that does hospital and nursing home rounds that is wanting us to do the billing for her, we have never done this type before. But, she makes it sound as though she can do billing without being under a physician. I just don't think this is true and before we go any further with her I was hoping somebody out there as some input on this.



Thank you,
Sherry

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4701
    • Solutions Medical Billing
Re: APN BILLING
« Reply #1 on: March 20, 2012, 08:12:31 AM »
If she is credentialed with insurance carriers it is fine.  Has she already been seeing patients and being paid and is now just wanting to switch to you for billing or is she just starting up?
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

srob48

  • Newbie
  • *
  • Posts: 12
Re: APN BILLING
« Reply #2 on: March 20, 2012, 09:26:06 AM »
Thank you for your reply. And to answer your question yes, she has been seeing Pt's and is wanting to switch to us for her billing, the only problem is, in the state of Arkansas she must have a M.D. sign her orders and she must document everything that is done (naturally) What we did find out was she was using a doctors submitter number that she did NOT have permission to do and he had no idea how she even got this information in order to do this. So, she seems a little scary to us anyway. I do know as I said in Arkansas she has to have the orders documented from a doctor, we just aren't sure if this is the doctor at the nursing home that is the doctor for this pt or if she has to be associated with a clinic. I hope this all makes sense. We have really more or less decided to tell her we can't do her billing because of some of the things we have found out, but, if we are approached by another APN we would like to know what the rules are for their billing.


Thanks again!
Sherry

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4701
    • Solutions Medical Billing
Re: APN BILLING
« Reply #3 on: March 22, 2012, 08:20:30 AM »
If she is using a drs submitter number without permission that is scary.  I definitely would not want to be a part of that.  The rules for APN's vary from state to state and I really don't feel comfortable commenting on Arkansas since I'm not familiar.  I think most states do require an MD to sign off.  Good luck!
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

PMRNC

  • Hero Member
  • *****
  • Posts: 4213
    • One Stop Resources & Networking for Medical Billers
Re: APN BILLING
« Reply #4 on: March 22, 2012, 11:26:22 AM »
If you are doing physicals for kids like for sports outside the well care mandated coverage for your state, they probably don't cover them because the schools have dates where physicals are given to be cleared for sports now.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

srob48

  • Newbie
  • *
  • Posts: 12
APN BILLING
« Reply #5 on: April 18, 2012, 01:05:12 PM »
Hi,
  OK we have been asked by another APN to do her billing, we have set her up with our software and Medicare etc. And they are going through our clearinghouse with no problem. My question is, we really don't know what to charge for her services, we haven't been able to find a fee schedule for their services. Does anybody out there know what the reimbursement usually is for an APN? This one is once again one that does nothing but see nursing home pts and uses is mainly wanting us to use the 99307 CPT code. Thanks in advance for any suggestions, answers etc.

Sherry

PMRNC

  • Hero Member
  • *****
  • Posts: 4213
    • One Stop Resources & Networking for Medical Billers
Re: APN BILLING
« Reply #6 on: April 18, 2012, 05:31:58 PM »
Weren't you given the charges? What where they charging before?
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

srob48

  • Newbie
  • *
  • Posts: 12
Re: APN BILLING
« Reply #7 on: April 19, 2012, 10:43:37 AM »
NO SHE IS WANTING TO CHARGE AS IF SHE IS A DOCTOR, WE HAVE TOLD HER SHE WON'T BE PAID THAT MUCH AND WOULD HAVE HUGE WRITE OFFS.

THANK YOU,
SHERRY

PMRNC

  • Hero Member
  • *****
  • Posts: 4213
    • One Stop Resources & Networking for Medical Billers
Re: APN BILLING
« Reply #8 on: April 20, 2012, 06:09:39 PM »
I have to mimic what Michele Said:

 
Quote
If she is using a drs submitter number without permission that is scary.  I definitely would not want to be a part of that.  The rules for APN's vary from state to state and I really don't feel comfortable commenting on Arkansas since I'm not familiar.  I think most states do require an MD to sign off.  Good luck!

Now she wants to be reimbursed the same as a physician and wants you to just go pull numbers out of the air?  She doesn't sound like a client I would take on. Be careful.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

srob48

  • Newbie
  • *
  • Posts: 12
Re: APN BILLING
« Reply #9 on: April 23, 2012, 10:41:03 AM »
Thank you all for your information, we have had her claims go through to Arkansas Medicare but all have been denied, so it was a trial run with her, and we have decided it's not going to be worth our time to do this.She is obviously not sending us all the correct information and we must have a ref. physician when this is charged out and she said she doesn't have all their names. So as much as we want to grow in our company, we don't need one bad apple to bring the whole company crashing down! But for future reference ANY information on billing for APN's or PA's will be greatly appreciated. This is just a field I haven't dealt with before and more and more of them are popping up!  ;)

Thanks again everybody!
Sherry

P.S. This website is GREAT! I am wanting to get a couple of your books, but, can't decide on which ones I should start out with, so if anybody has an opinion on that please pass it on!

PMRNC

  • Hero Member
  • *****
  • Posts: 4213
    • One Stop Resources & Networking for Medical Billers
Re: APN BILLING
« Reply #10 on: April 23, 2012, 10:19:51 PM »
Quote
P.S. This website is GREAT! I am wanting to get a couple of your books, but, can't decide on which ones I should start out with, so if anybody has an opinion on that please pass it on!

I swear I'm not biased.. go order wherever you want..but EVERY book Michele and Alice put out is worth reading!! :) My favorite is the one on contracts.. no other resource can touch what they have done. :)
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com