Effective Utilization of Non-Physician Practitioners for Hospitals and Physicians

Event Information
Product Format
Prerecorded Event
90 minutes
Product Description

Get All the Up-To-Date Info on Coding, Billing & Reimbursement for Non-Physician Practitioners

Healthcare organizations use non-physician providers (NPPs) to extend the therapeutic reach of physicians, increase patient satisfaction and add revenue to the bottom line. As the number of physician shrinks, roles for NPPs are expanding. In the near future they will play a pivotal role in dispensing healthcare.

Coding and billing for Non Physician Practitioners can be tricky business. There are numerous questions that generally tend to pop-up, some of them are, and not limited to:

  • Who are all these non-physician practitioners (NPPs)?
  • Is it possible for non-physician practitioners to bill separately to Medicare programs?
  • Do non-physician practitioners have to work incident-to physicians?
  • What are these joint/shared visits?
  • Where do I find out about state scope-of-practice laws?
  • How much payment do practitioners get paid under the Medicare Physician Fee Schedule?
  • What requirements do NPPs have and how do they relate to physicians?
  • NPPs involvement in provider-based clinics and Rural Health Centers (RHCs)?
  • Can special compliance issues affect NPPs?
  • How can NPPs relate to Medicare physician supervision rules?
  • Is it possible for NPPs to start their own independent practices?

Struggling to find answers to these questions, or perhaps you have other questions on your mind? Join expert speaker Duane C. Abbey Ph.D., who takes you through all these challenges to effectively utilize non-physician practitioners in this session.

Session Highlights:

  • To review the range and type of non-physician practitioners that are utilized by physicians, clinics and hospitals.
  • To appreciate how non-physician practitioners are reimbursed for services under Medicare and other private third-party payers.
  • To understand proper coding conventions and utilization of modifiers for non-physician practitioners.
  • To understand the difference between ‘freestanding’ situations and ‘provider-based’ situations.
  • To review the interplay between the MPFS and APCs for non-physician reimbursement in different settings.
  • To appreciate the concept of ‘incident-to’ and the differences in interpretation between physician/clinic situations and hospital situations.
  • To reviews the physician supervision requirements under Medicare for NPPs.
  • To understand the proper use of shared/joint visits.
  • To work through several case studies illustrating the coding, billing and claims filing process and differences in payment.
  • To review the important compliance issues, including the Place of Service (POS), surround the use of NPPs.

Session Agenda:

  • Non-Physician Practitioner Overview
    • Types of NPPs
    • Medicare versus State Law Requirements
    • Utilization of NPPs
    • Reimbursement Issues for NPPs
    • Compliance Issues for NPPs
  • Professional vs. Technical Component Payment
    • RBRVS Review
      • Relative Values
      • Place of Service Differential
      • Examples – Reduced Payment for NPPs
    • APC Review
    • Freestanding versus Provider-Based Status
    • Private Practice for NPPs
    • Medicare Enrollment
  • Non-Physician Practitioners – Compliance
    • The ‘Incident-To’ Concept
      • Freestanding Situation
      • Provider-Based Situation
    • Place of Service (POS) Considerations
    • Collaborative Agreements and Other Requirements
    • Shared/Joint E/M Services with Physicians
    • Physician Supervision Requirements
  • Examples and Case Studies
    • Nurse Practitioner in Medical Practice
    • Physician’s Assistant in Provider-Based Clinic
    • Clinical Nurse Specialist in Hospital Setting
    • Nurse Practitioner at Urgent Care Center
  • Sources for further information

Who should attend?

  • Coding Personnel
  • Billing and Claims Transaction Personnel
  • Charge master Coordinators
  • Clinic Managers
  • Financial Analysts
  • Compliance Personnel
  • Nurse Practitioners
  • Physician’s Assistants
  • Clinical Nurse Specialist
  • Speech-Language Pathologists
  • Nurse Midwives
  • Physicians and Other Interested Personnel

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Order Below or Call 1-844-384-4744 Today

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About Our Speaker

Duane Abbey Hospital Coding & Compliance Expert

 Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrolment and other financially related concerns of organizations....   More Info
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