Contents tagged with compliance
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Doctors report insurers are auditing billing procedures for services provided by NPs, PAs
Physicians should examine insurer contracts, provider policy and procedure manuals to ensure compliance
If you employ nurse practitioners or physician assistants, you should make sure you’re complying with each payer’s protocols when billing for services provided by nonphysicians. TAFP has recently heard from members who thought they were billing properly but have found themselves under investigation by payers. If these practices are found to be out of compliance, they may owe payers substantial refunds.
Many payers pay reduced fees for services provided by NPs and PAs but the rules and billing procedures doctors should follow when filing claims differ from payer to payer. For instance, Blue Cross Blue Shield of Texas pays 15 percent less for services provided by NPs or PAs than they would for services provided by the supervising physician. The insurer requires that practices include a “Modifier SA” when filing claims to indicate that a service was performed by an NP or a PA.
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TAFP members: I’m here to help
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TAFP members: I’m here to help
By Bradley Reiner
Did you know?
Did you know the Texas Academy of Family Physicians has a practice management consultant representing you?
Did you … more
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Get answers to your practice management questions through new TAFP partnership
Get answers to your practice management questions through new TAFP partnership
posted 02.12.08
TAFP has partnered with a practice management consultant, Bradley Reiner, to provide staff and … more
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Texas Family Physician - Vol. 64 No. 4, Fall 2013
Go to the TFP archive
View the virtual issue
President’s letter
Perspective
CONTENTS
A labor of loveIn a time of narrowing scope for family medicine, four family physicians in a … more
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Compliance and documentation: Lessons learned
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Compliance and documentation: Lessons learned
By Bradley Reiner
I’ve been a practice management consultant for 13 years. I worked 10 years for the Texas Medical Association. I’ve … more
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Are you ready for the RAC?
RECOVERY AUDIT CONTRACTORS
Are you ready for the RAC?
By Bradley K. Reiner Practice Management Consultant, Reiner Consulting and Associates
I suppose when I ask, “Are you ready?,” you may be … more