Non-physician providers are healthcare professionals who offer medical services and are not doctors. A non-physician provider (NPP) is a healthcare provider who is not a physician but who practices in collaboration with or under the supervision of a physician. NPPs may bill payers directly, rather than billing under a physician, in certain circumstances. Examples of […]
Provider-Based Physician Services Providers may retain physicians on a full-time or part-time basis in, for example, the fields of pathology, psychiatry, anesthesiology, and radiology, and in many instances (especially in teaching hospitals) in other fields of medical specialization as well. Any one of these physicians may be engaged in a variety of activities including teaching, […]
Physician Self-Referral Law (Stark Law) Basics The Physician Self-Referral Law, commonly referred to as the Stark law, prohibits physicians from referring patients to receive Designated Health Services (DHS) payable by Medicare or Medicaid from entities with which the physician or an immediate family member has a financial relationship unless an exception applies. Financial relationships include […]
A couple of years ago medical professionals treated credentialing as an optional or unnecessary step to increase their clientele. Nowadays the scenario has completely changed, physicians are emphasizing not only on services but also on credentialing. The process of verifying and organizing professional records of the doctor is termed as physician credentialing in the healthcare […]
CMS is revising certain Medicare regulations to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the Medicare program during the public health emergency (PHE) resulting from the COVID-19 pandemic. To that end, the IFC makes temporary changes to certain policies that will affect Medicare billing […]
Critical care services must be medically necessary and reasonable. Services provided that do not meet critical care services or services provided for a patient who is not critically ill or injured in accordance with the above definitions and criteria but who happens to be in critical care, intensive care, or other specialized care units should […]
CMS received approval for a new Medicare Enrollment Application for physicians and non-physician practitioners (CMS-855I dated 12/2018). Many changes are minor; the major ones reduce provider burden: Eliminated reporting for advanced diagnostic imaging, Clinical Laboratory Improvement Amendments number, and the Food and Drug Administration radiology certification number Expanded instructions for individual and group affiliations to […]
The changing political trends have affected the way physicians are implementing changes in their functioning at work, be it at clinics or hospitals. Keeping up with the times is the need of the hour and hence never knowing which way the winds will blow, physicians should initiate certain goals that can help them ride the […]
MACRA – Medical Access & Chip Re-authorization ACT is a new initiative, a new reform that has assured to have a better and efficient modified version of medical service system of the USA from the previous one. It is a bilateral federal legislation law signed, which was made official and announced on 16th April, 2016. […]
We are stepping into the New Year! 2015 has been a roller coaster ride with multiple healthcare changes that took place, the greatest of them being the implementation of ICD-10. Healthcare centers handled these changes pretty well, of course with effects that were pretty much visible. Striking a balance between the administration work and patient […]
