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Non-Physician Practitioner Coding

Perform a prospective or retrospective review of non-physician practitioner claims to determine accurate and complete capture of services, documentary support for services claimed and revenue optimization through, as well as compliance with, "incident-to" and "direct" billing of said services. This review also includes a focus on "collaborative practice" requirements, "supervision" requirements, type of service restrictions, new vs., established patient criteria and level of service/site of service issues. The non-practitioners most at risk for compliance issues are:

• CRNA's
• CNS's
• CNM's
• NP's
• PA's
• RD's
• PT's
• OT's
• RT's
• ST's
• Podiatrists
• Chiropractors
• Optometrists
• Audiologists

If the professionals are providing services in an inpatient setting and/or are employed by an Institution, compliance with these additionally regulated areas can be provided as an add-on service.

Perform a credentialing review of advanced practice professionals to determine compliance with Medicare and Third Party Payer regulations governing minimal education and licensure requirements, assuring reimbursable claims.

A "shadow" review service for Third Party Payer "Medical Claim Reviews" is available as an add-on or stand alone engagement.

Reviews of claim denials, suspends and reductions are available as well as expert guidance in preparing re-submissions

Preparing/supporting Payer appeals

Litigation support in Medicare abuse/fraud actions is one of our specialties.
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Seminars on coding and documentation for advanced practitioners.

Billing seminars for non-physician practitioner services.

"Update Seminars" are available; focusing on regulatory change

All seminars are available on videotape at an additional charge.

Additional services are available (including all listed on the physician compliance page)