General Category > General Questions
billing nurse practitioners
RichardP:
We researched this issue for our clients who wanted to add NPs to their office. The term "supervision" has a specific meaning and is defined by each State. A health-care attorney familiar with your State laws can help you determine how your State defines supervision.
For California, "supervision" is defined as being in the same room with the NP all the way up to being in the same city and immediately available by phone. That is, the NP is considered to be "supervised" by the doctor so long as the doctor is in the same city as the office the NP is practicing in, and the doctor is immediately available by phone.
As an aside, think how this could work in California. Doctor could have two offices. Sees the wealthier patients in one office. Sees the Obamacare patients in the other, where the NP does the work. Has iPads in each office, connected by Skype. NP doesn't know what s/he is looking at. Skypes the doctor, and points the iPad camera at the target issue. Doctor sees the image on his iPad screen and offers his informed opinion. NP says "thanks", breaks the connection, and gets on with the work.
Billers - sell that idea to your clients. They can increase their patient load and make money off of Obamacare, all without increasing their own level of stress. But only if your State defines supervision as "being in the same city, immediately available by phone". And only if the income from the Obamacare office is high enough to cover all expenses associated with the second office and the NP, etc. (That idea is presented with tongue only slightly in cheek.)
Merry:
Love it..You are definitely the creative one.
PMRNC:
This is not related to NP however I once did a big whistleblower case on a provider not following the "supervision rules". He was going away on vacations and still I was getting charge slips for the type of provider that had to be supervised. Be careful.
PMRNC:
--- Quote ---Billers - sell that idea to your clients. They can increase their patient load and make money off of Obamacare,
--- End quote ---
There is no such thing as "OBAMACARE" EVERY practice has to take a look and review very carefully ALL plan contracts for the "All products clause". THERE is no Obamacare.
dermbillerPA:
--- Quote from: PMRNC on February 17, 2014, 06:14:35 PM ---
--- Quote ---Billers - sell that idea to your clients. They can increase their patient load and make money off of Obamacare,
--- End quote ---
There is no such thing as "OBAMACARE" EVERY practice has to take a look and review very carefully ALL plan contracts for the "All products clause". THERE is no Obamacare.
--- End quote ---
Thank you for saying that!!!!
I just went through this process. MD adding a PA. I had to research/call every MD contracted carrier to get their requirements. About 50% don't credential NPP's so must be billed as incident to. Some just wanted the MD to update his demographics and the others wanted new applications. There is a CMS MLN Matters Article Number SE0441 regarding incident to. I was not able to attach the pdf article to this msg. CMS does require direct supervision.
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