Q&A New Physician billing questions!!

[Elssy G. Romero]

Im Trying to find out about best practices for brand-new physicians and other concepts like "incident to billing", holding Medicare claims or other concepts.
My office manager asked me about this but I am not sure what to answer can someone please give me some advice As we going to have a new doctor on July in practice and all his credentialing is in process...Please I need your help.

 

[Alicia Scott]

This is an excellent question. I have a friend who is a compliance officer for a large physician practice. Let me get your question to her and see if we can't get information for you. In the mean time. I know we have some other coders in the group that are compliance officers. They may be able to jump in right away.

Thanks for a great question. I think this will help others.

 

[Alicia Scott]

Here is what I found out from a friend. Hope this helps:

We usually only let that physician file claims incident to another physician. Which means that other physician either has had to have seen the patient in recent months or has to go in see the patient, be in the office suite and be involved in the care and assessment of the presenting problem.
We bill incident to for a few weeks and then towards the end of the credentialing waiting time (usually 3-4 weeks in) we begin holding claims until provider numbers start coming in for insurance filing and at that point do not file claims incident to.

Vanessa Ramirez, CPC, CHC * Compliance Officer