Catalog Number : cra1626
Title : Coding, Billing & Reimbursement for NPPs
Speaker : Duane Abbey

Webplay Recording Date : 8-12-2009
Webplay Price : $ 225 for two weeks viewing

Webinar Level: Intermediate/Advanced

Target Audience:

• Coding Personnel
• Billing and Claims Transaction Personnel
• CVIR Personnel
• Chargemaster Coordinators
• Financial Analysts
• Compliance Personnel
• Nurse Practitioners
• Physician’s Assistants
• Clinical Nurse Specialist
• Speech-Language Pathologists
• Nurse Midwives
• Physicians and Other Interested Personnel

Webinar Objectives:

• To review the range and type of non-physician practitioners that are utilized by physicians, clinics and hospitals
• To appreciate how non-physician practitioners are utilized in various settings and the impact on reimbursement through the Medicare program
• To understand the difference between ‘freestanding’ situations and ‘provider-based’ situations
• To briefly review the payment methodologies for RBRVS (Resource Based Relative Value System) and APCs (Ambulatory Payment Classifications)
• To appreciate the concept of ‘incident-to’ and the differences in interpretation between physician/clinic situations and hospital situations
• To work through several case studies illustrating the coding, billing and claims filing process and differences in payment
• To review the important compliance issues, including the Place of Service (POS), surround the use of NPPs

A few of the Topics that will be covered:

• Non-Physician Practitioner Overview
  • Types of NPPs
  • Medicare versus State Law Requirements
  • Utilization of NPPs
  • Reimbursement Issues for NPPs
• Professional versus Technical Component Payment
  • RBRVS Review
    • Relative Values
    • Place of Service Differential
    • Examples - Reduced Payment for NPPs
  • APC Review
  • Freestanding versus Provider-Based Status
  • Private Practice for NPPs
• Non-Physician Practitioners - Compliance
  • The ‘Incident-To’ Concept
    • Freestanding Situation
    • Provider-Based Situation
  • Place of Service (POS) Considerations
  • Collaborative Agreements and Other Requirements
• Examples and Case Studies
  • Nurse Practitioner in Medical Practice
  • Physician’s Assistant in Provider-Based Clinic
  • Clinical Nurse Specialist in Hospital Setting
  • Nurse Practitioner at Urgent Care Center
• Sources for Further Information

Prerequisites for Participating:

• General knowledge of non-physician practitioners and associated services. Some knowledge of physician practices and hospital clinics is useful.

Attendance Certificate: Upon attending this course you will receive a 1.5 Contact Hour Attendance Certificate. There is usually a reciprocal agreement between state associations to allow these to count for each state. If you have any questions, please ask your state association.

Full tuition is refunded immediately on request if the participant has not been sent the program materials and instructions. Once the instructions (including access codes) have been sent, a full refund will be issued only after the program runs and it is verified that the participant did not access the program.