The Incident has been around for many years whereas shared care is a more recent CMS billing opportunity. Many physician offices are confused as to the correct way to bill these types of services and how they differ. Recent CMS changes to their shared care policy have added to the confusion. Billing incorrectly leads physician offices to the risk of audits, paybacks, and fines. This Webinar will explain the differences and help physician billers correctly reporting both types of services.
- Define “incident to” services and correct use
- Define shared care services and correct use
- Correctly report the applicable place of service codes for both services
- Identify professionals that may fall under the incident to services policy
- Understand the difference between supervision versus incident.
- Review changes to supervision of incidents to services when the public health emergency (PHE) ends
- Identify services that may qualify for split shared care.
- Know the reimbursement implications when billing these services.
- Do private payers follow these rules
Areas Covered in the Session:
- Incident-to policies
- Shared care policies
- Supervision policies
- Provider eligibility
- Recent changes to the incident and shared care services
- Private payer interpretations of CMS policies
- Reimbursement considerations
- Clinic managers
- Denial management staff
- Accounts payable staff
- Office Managers
- Denial resolution teams
- Insurance payers
- Payment policymakers
- Billing Staff
- Coding Staff
- Compliance officers
- Physician and Non-physician Practitioners
- Insurance Company Claims Reviewers
Jan Rasmussen, PCS, ACS-OB, ACS-GI, – As a healthcare consultant Jan has more than 35 years of experience in physician billing, reimbursement, and compliance. Jan is currently the owner of Professional Coding Solutions, a healthcare consulting firm. She has been a Certified Professional Coder (CPC) since 1992 with active membership in the American Academy of Procedural Coders (AAPC). As a member of the AAPC, Jan previously served on their Advisory Board as the liaison to the AMA, has been a speaker for the AAPC annual conference as well as contributing to the development of AAPC’s independent study and university education programs and proficiency tests. In 1994, she was honored by AAPC as Networker of the Year. Jan was also a Regional Governor for the American College of Medical Coding Specialists (ACMCS) serving as Chair of the Ethics committee and a member of the Examination committee.
In her role as a physician consultant, she has participated in physician coding and documentation reviews including OIG government PATH and Campus audits, and designed and conducted physician coding seminars nationwide. She has been a guest speaker for several conferences sponsored by United Communications, Inc//Decision Health, AAPC as well as Coding Institute Specialty Conferences.
In previous consulting positions, she was responsible for developing and conducting seminars for basic, intermediate, and advanced ICD-9-CM and CPT, teaching physician guidelines as well as special seminars for OB/Gyn, Orthopedics, Urology, Gastroenterology, General Surgery, ENT, Cardiology, Emergency Medicine and Evaluation and Management. In her role as an educator, she has been teaching E/M documentation and auditing to both physician and coding audiences since 1992 when RBRVS was first implemented.
Jan has also worked for several major health insurance payers in Wisconsin, was a coding advisor to the WPS Medicare Carrier Advisory Committee, and served as the coding and reimbursement coordinator for a 37-provider, staff model HMO clinic. As the coding and reimbursement coordinator, Jan was responsible for physician office, hospital, surgical, and nursing facility coding charge ticket development, fee development, reimbursement analysis, claims analysis, and physician education.
Snippet From Our Previous Session