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top10 most frequently asked questions about n p billingand（全球对于n p billingand最常见问题）.doc

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660 N Central Expressway, Ste 240 Plano, TX 75074 469-246-4500 (Local) 800-880-7900 (Toll-free) FAX: 972-233-1215 info@ Top 10 Most Frequently Asked Questions About NP Billing and Reimbursement MEDSCAPE ARTICLE September 2007 Incident-to Billing Question 1: If an NP is working under an independent contract with a physician, can the NPs services be billed under the physicians provider number, to get 100% of the Physician Fee Schedule rate? Answer: Yes, under Medicare rules, if the other parts of the incident-to rules are followed (ie, the physician is present in the suite, the physician has conducted the initial visit, and the physician remains an active participant in the management of the patient). The CMS clearly stated in the Federal Register on November 1, 2001, that the employment relationship is irrelevant to incident-to billing, as long as the reassignment rules are followed. The rules on incident-to billing are Medicares rules. Other insurers may or may not require adherence to the incident-to rules when billing an NPs work under a physicians name. Physicians and practice managers wanting to submit bills under a physicians provider number for services performed by an NP must read the policies of and contracts with each insurer and MCO with which the practice does business and, if finding nothing to address the practices provider arrangement, query the payer, in writing, before assuming that all bills submitted under a physicians name will be paid. Physician Presence While an NP Is Seeing Patients Question 2: Is a physician required to be on site or available within any specific time frame while an NP is working? Answer: The answer regarding physician presence depends upon the provider under whose name and number the visit will be billed, the state where the services are provided, and the insurer. For example, if billing Medicare under an NPs provider number, a physician need not be on site unless state law requires physician presence. However, if