Author Topic: APRN billing  (Read 1955 times)

mhooyer

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APRN billing
« on: February 20, 2014, 10:18:10 AM »
Hello All,

I am new to the billing field, So need a bunch of help, lol.   Possibly getting ready to sign a APRN.  She has her own practice by herself. Has one nurse.  She needs help getting the most possible reimbursement she possibly can receive since she gets less anyone for just being a APRN.  She has billed things out before and later finds out she cannot get reimbursed for certain items, etc.  Need some help or a resource on this. Is anyone billing for just a APRN with their own practice?  Need help, suggestions.  Thanks.

Matt

Michele

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Re: APRN billing
« Reply #1 on: February 20, 2014, 12:28:43 PM »
Wow, that is a tough one.  I have not billed for any APRNs that had their own practice.  Reimbursement would definitely be lower on average.  I found the following site had a bit of information on billing for APRNs that might be helpful:

http://journals.lww.com/jwocnonline/Fulltext/2012/03001/Reimbursement_of_Advanced_Practice_Registered.4.aspx

I hope that helps.

Michele
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Merry

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Re: APRN billing
« Reply #2 on: February 20, 2014, 12:45:13 PM »
I would check with your state to be sure to find out what services she can render that are within her scope of practice in order to get reimbursed.she would need her own NPI. Is this specialty the same as a nurse practitioner?

mhooyer

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Re: APRN billing
« Reply #3 on: February 20, 2014, 01:32:23 PM »
Might be a dumb question, but how do I check with my state?  She has her own NPI.  Nurse Practitioner and APRN are the same thing.  They have just added the R in there now, but it is the same thing. 

Merry

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Re: APRN billing
« Reply #4 on: February 20, 2014, 02:33:46 PM »
I would contact the licensing board in your state for her specialty.

mhooyer

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Re: APRN billing
« Reply #5 on: February 20, 2014, 04:18:58 PM »
Merry,

I did that and she said all they do is licensing there and she did not know where to send me.

Matt

Merry

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Re: APRN billing
« Reply #6 on: February 20, 2014, 04:46:31 PM »
Then I would check with your insurance companies. Also check with thenlucal and national associations. If you are new to billing, this can be an overwhelming endeavor.

PMRNC

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Re: APRN billing
« Reply #7 on: February 21, 2014, 08:37:16 AM »
You may not have asked the right questions, the licensing board "licenses" therefore they know the services/scope of the license. You need that to move forward.
Linda Walker
Practice Managers Resource & Networking Community
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www.billerswebsite.com

Michele

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Re: APRN billing
« Reply #8 on: February 22, 2014, 02:46:58 PM »
Most insurance carriers do recognize NP's independently.  I would check with each of the major insurance carriers and make sure that they credential, and reimburse NP's if not directly supervised by a physician.  Medicare does.  Also, I'm a little redfaced....  :-[   ....I actually am currently billing for an NP who has her own practice.  She is in Maryland.  I wasn't even thinking when I said I wasn't.  Anyway, she does home visits for patients.  Aetna will not recognize her (or any NPs without supervision).  Medicare does.  Others do too.  Just check with each major carrier for your area.

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