Secrets To Correctly Billing Shared Care And “Incident To” Services In 2024

Description

Many physician offices are confused about the correct way to bill these types of services and the documentation necessary to support billing. They are significantly different and billable in different settings. Incident has existed for many years, whereas shared care is a more recent CMS billing opportunity. Current CMS changes to their shared care policy have added to the confusion.

Reduce the risk for audits. Paybacks and possibly by billing correctly. Findings of incorrect billing on a payer audit can lead to future pre and post-payment reviews, contributing to reimbursement delays. This Webinar will explain the changes for 2024 and identify documentation requirements for shared and incident care.

Speaker

Jan Rasmussen, PCS, ACS-OB, ACS-GI, – As a health care consultant Jan has more than 45 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. As a member of the American Academy of Professional Coders (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 contributed to the development of the original AAPC’s independent study, 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.

Learning Objectives

Define shared care services and correct use.
Define “incident to” services and correct use.
Correctly report the applicable place of service codes for both services.
Identify services that may qualify for split shared care.
Identify professionals that may provide under incident to services policy.
Understand the difference in supervision versus incident.
Know the reimbursement implications when billing these services.
Know what to look for when auditing these types of services
Do private payers follow these rules

Areas Covered

Shared care policies
Incident to policies
Supervision policies
Provider eligibility
Recent changes to shared care services
Private payer interpretations of CMS policies
Reimbursement considerations

Background

Shared care and Incidents are specific Medicare billing policies. CMS and the AMA made some significant changes regarding shared care for 2024. Some other payers may follow these rules also.

Who Should Attend

Providers
Coders
Clinic managers
Denial management staff
Accounts payable staff
Auditors

All Days