Case Studies to Reduce Your Compliance Risks with Non Physician Practitioners

Event Information
Product Format
Prerecorded Event
Elin Baklid-Kunz, MBA, CHC, CPC, CPMA, CCS
60 minutes
Product Description

Learn How to Reduce Risks of Fraud and Denials When Working with Non-Physician Practitioners

Non Physician Practitioners (NPPs) are playing an important role in every physician practice; however, non-compliant billing puts the practice of physicians at risk for fraud and denials. Many physicians are unaware of it.

This informative session by our expert speaker, Elin Baklid-Kunz, MBA, CHC, CPC, CPMA, CCS , will discuss how to avoid the risks of reduced payments; dealing with increased government scrutiny; and handling compliance issues. You’ll also understand Medicare’s requirements for incident-to and split/shared services. Plus, you’ll get handouts including self-audit checklists for shared visits and incident-to services.

Session Highlights:

  • Incident-to Supervising physician clarified in 2016 Medicare Physician Fee Schedule
  • Medicare’s Shared/split visits vs to “Incident-to”
  • Documentation and Billing Requirements
  • Audit Tips & Case Studies
  • Education tools to improve compliance

Session Agenda:

  • 2016 Medicare Incident-to Updates & Focus on NPPs
    • MPFS CY2016: Incident-to changes
    • 2009 OIG report: prevalence & qualifications of NPPs
    • 2013 OIG: error rate for Incident-to services performed by non physician
    • CMS CERT findings: Split/Shared/E/M services
    • Physicians duty to know: Certification Claim Form & Enrollment
    • CMS-1500 claim Form: Incident-to certification
    • OIG recent example Incident-to: false and fraudulent claim
  • NPP Risk Areas & Audit Consideration
    • Defining NPPs with examples
    • CMS booklet for APRNs & PAs
    • Auxiliary Staff
    • NPPs Services
    • Billing options for NPPs
    • NPP risk areas
    • Incident-to risk areas
    • Special audit considerations
    • Reviewing sources for audit concepts
  • Incident-to services
    • Physician involvement
    • Incident-to documentation
    • Billing Options: established patient & new problems
    • New or established problem Biopsy?
    • New or established problem? suspected Basal Cell
  • Split/Shared E/M Visits
    • Medicare’s Split Shared E/M visit defined
    • Split/Shared E/M Visit Basic Requirements
    • Examples Split/Shared E/M visit
    • Split/Shared E/M Visits Applicable E/M Codes
    • Split/Shared E/M Visits; Do Not Apply To?
    • Documentation Split/Shared E/M Visit
    • Examples of Unacceptable Documentation
    • Scribing?
    • Consider This Example: Split/Shared E/M Visit?
    • Private Payer Differences
    • Supervision of Diagnostic Tests
    • FAQs

Who should attend?

  • Coding professionals
  • Billing specialist
  • Practice managers
  • Him directors
  • Compliance officers
  • Case managers
  • Physicians

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

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About Our Speaker

Elin Baklid Kunz - Medical Billing Coding Expert

Elin Baklid-Kunz is an expert in medical coding compliance who supports clients in matter across the United States with over 20 years of experience in the field.

Ms. Kunz is a national speaker and published author. Recent speaking engagements include the 2018 European Symposium on Ethics and Governance in Paris for the Organization of Economic Cooperation and Development; American Bar Association 2018 Physician Legal Issues Conference,  2017 American...   More Info
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