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 […]
Billing by Non-Physician Providers (NPPs)
Basics of Provider-Based and Teaching Physician Services
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, […]
Understanding Physician Self-Referral Law (Stark Law)
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 […]
Physician Credentialing Services in 2020
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 […]
FAQs on Medicare Billing for Physicians in COVID-19 Pandemic
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 and Medical Necessity
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 […]
Medicare Enrollment Application Information: MBC
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 […]
How To Explore Untapped Potential Of Your Practice?
Today, the majority of deaths worldwide are due to four noncommunicable diseases such as cancer, cardiovascular disease, type 2 diabetes, and respiratory diseases; most of these deaths are potentially preventable. Four sets of behaviors contribute to the high and growing burden of noncommunicable disease: consumption of tobacco, alcohol, and highly processed foods, as well as […]
How Physicians Can Implement Patient Experience?
There are patients who are angry, disrespectful, and rude; basically difficult patients who demand specific drugs or tests, even when they’re not indicated; and patients who growl at everyone, act suggestively to the nurses, or ask you to submit a fraudulent bill so the insurer will cover the cost of treatment. Taking steps to Implement […]
Guiding Principles Every Physicians Should Know About Patient Environment
Not to be confused with traditional ideas of patient care, patient-centered care pushes the boundary of healthcare to create systems and processes that are truly custom-made to enhance the health, well being, and treatment plans for both health professionals and patients. Recently, the Mountain State Healthcare Alliance (MSHA) received the 2012 National Healthcare Award from […]