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APN BILLING

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srob48:
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:
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?

srob48:
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:
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!

PMRNC:
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.

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