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]

I will check with a compliance officer friend and see if I can get something for you.

 

[Ruth Sheets]

Alicia told me she is working on an answer for you. She has just moved so she is still working on settling in to her new place. She will get to it soon; hope it will still help you or someone else in a similar situation!

 

[Alicia Scott]

Sorry for the delay. I will get an answer for you right away. Another message sent out to my friend today. This one slipped right by me. I know she answered me before but I can not find her response. Again, sorry for letting this one get by me.

 

[Alicia Scott]

Here you go. Great Best Practice from Vanessa a compliance officer with a multi physician organization/facility.
Best Practice for New Providers:
As soon as the contract is signed, get copy of license and begin the credentialing process. Medicare usually comes in first so you may begin billing Medicare immediately. Incident to billing can begin on day one assuming license and contract paperwork has been completed. We try not to hold Medicare/Medicaid claims but when we get a verbal that credentialing will begin as of application date, then we will.
As the provider to send you fee tickets or list of patients that he/she saw for the first couple of weeks just so you can go over the documentation and codes billed. Feedback is important during this time. You will also get a good feel for how long it takes this provider to complete records and turn in tickets for billing.
Audit 10% of records approx. 60 days in and meet with Provider for feedback.

Hope this helps!