Billing > Billing

Billing for a Supervising Physician

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aknittel914:

--- Quote from: kristin on November 02, 2014, 07:33:10 PM ---Because it mentions telecommunications, it would seem the SP does not need to be in the same location as the PA when the PA is seeing patients.

--- End quote ---

Thank you!

That being said, lets say Florida says the SP does not need to be in the same location. Ultimately, if the payer rules that the SP DOES need to be in the same location, that is the rule I need to follow. Correct?

On a similar note, this potential client has asked "you know how to bill out-of-network, right"... Well yes I do... and he says "because we want to make sure we bill out-of-network whenever we can, we have some providers that are credentialed and some that are not" I take this as he is implying that I bill the service under whichever provider will get paid the best... In this situation would any of you say run as fast as I can, or should I try to do some more digging. Perhaps the client is ignorant in the fact that you can only bill incident to if specific qualifications are met. If I correct his ignorance before I start billing am I safe, or do I just run :) Thanks for any advise!!

kristin:
I think state law trumps the payer, but am not positive about that. Someone else may know that answer to that. I swear I saw a mention of this with Medicare, where they mentioned state laws being what to follow, but I can't find it now. If I do, I will post it.

As for what you are being told by the potential client, at face value, it does seem like they are telling you to do something fraudulent. Whether that is because they are ignorant of how to bill, or are straight-up trying to be fraudulent is another matter. You may want to clarify exactly what it is they are trying to tell you, and if it NOT due to ignorance, run for the hills.

PMRNC:
Whichever is stricter is actually the trump/superceder.   So if state law says they have to be there on spot, Medicare says certain availability" you would follow state.

aknittel914:
Thanks for the clarification!

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