Contents tagged with insurance
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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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How physician practices can prepare for a health care marketplace
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How physician practices can prepare for a health care marketplace
By Brian Klepper, Ph.D.
What is the path forward for physicians who want to remain in private practice, outside … more
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Opening soon: The health insurance marketplace
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By Samantha White
Since the signing of the Affordable Care Act in 2010, you’ve probably had many patients come to you for answers to a host of questions, but you can expect an … more
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What you don’t know can hurt you
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By Bradley Reiner
You’ve probably been reading more than you should about groups of doctors sending back money. Accusations of incorrect billings, fraudulent behavior, and false … more