WEBINAR: Non-Physician Providers: Compliant Billing

What kind of requirements are there for NPs, PAs and CNSs and how do they relate to physicians? Are there special compliance issues that affect NPs, PAs and CNSs? Are there any special concerns for CAHs relative to NPs, PAs and CNSs?

To answer these questions and more, come join us in this educational Webinar.

Webinar Objectives: 
review the range and type of non-physician practitioners that are utilized by hospitals, CAHs, and clinics of all types
discuss NPs, PAs and CNSs and their use by hospitals and clinics
review how non-physician practitioners are reimbursed for services under Medicare and other private third-party payers
discuss proper coding conventions and utilization of modifiers for NPs, PAs and CNSs
discuss the difference between ‘freestanding’ situations and ‘provider-based’ situations
review the interplay between the MPFS and APCs for non-physician reimbursement in different settings
recall the concept of ‘incident-to’ and the differences in interpretation between physician/clinic situations and hospital situations
review the physician supervision requirements under Medicare for NPs, PAs and CNSs
define the proper use of shared/joint visits
illustrate several case studies illustrating the coding, billing and claims filing process and differences in payment
review the important compliance issues, including the Place of Service (POS), surrounding the use of NPPs
review compliance issues relative to CAHs and RHCs

Webinar Topics:
Non-Physician Practitioner Overview
o Types of NPPs
o Medicare versus State Law Requirements
o Utilization of NPs, PAs, CNSs
o Reimbursement Issues
o Compliance Issues
o Hospitals vs. CAHs vs. Clinics
Professional versus Technical Component Payment
o RBRVS Review
? Relative Values
? Place of Service Differential
? Examples – Reduced Payment for NPPs
o APC versus Cost-Based Reimbursement
o Freestanding versus Provider-Based Status
o Private Practice for NPPs
o Medicare Enrollment
Types of Non-Physician Practitioner/Providers
o Template for Assessment
o Physician Assistants
o Nurse Practitioners
o Clinical Nurse Specialists
Non-Physician Practitioners – Compliance
o CFR Guidance
o State Level Laws and Scope of Practice
o Telehealth/Telemedicine
o Special CAH Conditions of Participation
o Assistant at Surgery
o The ‘Incident-To’ Concept
? Freestanding Situation
? Provider-Based Situation
o Place of Service (POS) Considerations
o Collaborative Agreements and Other Requirements
o Shared/Joint E/M Services with Physicians
o Physician Supervision Requirements
o CMS-855 Enrollment Issues
Examples and Case Studies
o Nurse Practitioner in Medical Practice
o Physician’s Assistant in Provider-Based Clinic
o Clinical Nurse Specialist in Hospital Setting
o Nurse Practitioner at Urgent Care Center
Sources for Further Information

Target Audience:
Coding Personnel, Billing and Claims Transaction Personnel, Chargemaster 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

 Faculty: Duane C. Abbey

Duane Abbey is a management consultant and president of Abbey & Abbey Consultants, based in Ames, Iowa. For over twenty years Abbey & Abbey, Consultants, Inc. has provided superior healthcare consulting services to hospitals, hospital systems, physicians, medical clinics and integrated delivery systems.
Abbey & Abbey, Consultants, Inc. specializes in healthcare consulting primarily in the areas of: 
Payment systems - reimbursement consulting
Delivery systems - organization of healthcare delivery
Compliance - developing compliance programs - emphasis in the coding, billing and reimbursement areas
In addition to his consulting, Dr. Abbey has been an invited presenter for hospital associations, medical societies, and other groups. He has also published both articles and books on health care topics.

Dr. Abbey earned his graduate degrees from the University of Notre Dame and Iowa State University.

Contact Hours: 
Nursing participants: This program has been approved for 1.8 contact hours by the Iowa Board of Nursing Approved Provider Number 339.

All other participants: Must attend the entire Webinar and complete a Webinar critique to receive a 1.5 Hour Attendance Certificate.
7/13/2017 10:00 AM - 7/13/2017 11:30 AM
United States


Thursday, 13 July 2017

7/13/2017 10:00 AM
10:00 AM - 11:30 AM
7/13/2017 10:00 AM
10:00 AM - 11:30 AM
7/13/2017 10:00 AM
10:00 AM - 11:30 AM
7/13/2017 10:00 AM

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