NP Insurance Enrollment Question-From Forum

Friday, September 2nd, 2011

Here is an interesting and common question that was posted in our forum.

8:16 pm
30 August 2011
webbly18
New Member
posts 1

I recently joined a practice where the NPs are billed under the physician even though the doctor is not always in the building.  The doctor was told verbally by an insurance company that as long as he is available by phone they may bill under him.  Is this correct?  It would seem they can only bill under the MD when present and when not changing a plan of care (in a pt previously seen by an MD) – as per Medicare.  The NPs are not currently credentialled on their own for insurance other than Medicare/Medicaid.  I assume each NP also needs to be credentialled for each insurance…

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Outsourcing your billing office

Sunday, January 29th, 2012

Many of our clients outsource their billing office to a third party but not all of our clients have had a good experience with this.  Unfortunately, many companies cut corners and hire workers (or don’t hire enough workers) who are uneducated in your specialty and ill equipped to handle the demands of your office.  If you are one of those offices considering outsourcing, just select judiciously.

We used to own a billing company and listed below are the guidelines that we followed.  You would be wise to use these to ensure your billing service can abide by these standards and has the technology or man power to perform these tasks.

DMEPOS Application Essentials

Tuesday, January 24th, 2012

Here are a few key things to remember when submitting an application to enroll your business in the DMEPOS (Durable Medical Equipment and Prosthetics/ Orthotics).  The applications required for enrolling a business or new location are 855s, CMS588

  • Remember that you need to send a complete application in for each new service location regardless if your business is already enrolled in DMEPOS at one of your current locations.
  • If you are a part B provider (i.e. Physician Office) and plan to enroll in DMEPOS, you must first complete the enrollment process for PART B prior to sending your application in for DMEPOS.
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Employee Salary vs. Exempt

Monday, December 12th, 2011

Here is an excellent article provided to through our partnership with the payroll service we use (ADP). You do not want to make a decision that will wind up with you in a lawsuit requiring you to pay penalties and overtime due to an employee.  This is something to consider when setting up your new medical practice.

TIP OF THE WEEK

‘Salaried’ vs. ‘Exempt’: Common Misconceptions

The terms “salaried” and “exempt” are often used interchangeably. However, simply because an employee is paid on a salary basis does not mean the employee is “exempt” under the Fair Labor Standards Act (FLSA). Rather, very specific tests must be met in order for an employee to be considered exempt.

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Conversion Factor Fee Calculator Now Available

Friday, October 7th, 2011

Ever read an insurance contract and wish you had an easy way to understand exactly what you are getting paid and how it compares to Medicare.  This tool will quickly tell you what the fee is you can expect along with how it compares to Medicare reimbursements for your area.  The tool has detailed instructions and we will be happy to help if you run into any issues.  You just have to make sure you don’t delete any of the formulas but you can always download again if you feel you messed it up. The tool is available in our resource center and also at the below link.

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PPS Racing

Friday, September 2nd, 2011

PPS and Mr. Eriksen is not afraid of taking risks which is evident by the fact that PPS was started in 2008 while most businesses were shutting doors and laying workers off. PPS has been very successful over the past few years and is launching a new marketing campaign in the form of Porsche Road Racing. Mr. Eriksen started racing go-karts at age 8 and cars by the age of 16, so it was only a matter of time before he got back at it again.

Categories : Press Room
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PPS CEO Meets Clark Howard

Friday, September 2nd, 2011

I had an interesting opportunity a couple weeks ago to speak with the purveyor of consumer advocacy, Clark Howard.  Myself and a friend/client of PPS (Dr. Ali Kasraeian MD http://kasraeianurology.com) met with Clark to discuss our idea of creating a radio program that will help patients take ownership of their health while sharing insight into the healthcare world from the physician’s point of view.  Our hope is to create interest and awareness of what goes on behind the scenes while providing patients an opportunity to ask important health questions.  I enjoyed meeting him and hope to have him on the show once when it is launched in 2011.

Categories : Press Room
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It’s Official- Practice Financing Now Available

Thursday, June 2nd, 2011

Physician Practice Specialists has entered now has access to some great financing opportunities for new and existing medical practices through our partnership with the practice finance division of Wells Fargo.  There are numerous options available to help physicians grow their businesses or help them get their dream off the ground.  The financing is available nationwide and is available to Physicians and Dentists.

Contact Andrew Eriksen at Physician Practice Specialists for more information.  PPS does not make a penny off of the loans or referrals

Office: 904.746.4664

andrew (at)  drcred.com

 

Physician Practice Financing, Financing Physician Practice Start-Ups

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DMEPOS Medicare Application Fee

Saturday, April 16th, 2011

Bad news for providers in the form of a new cost of doing business. Medicare has instituted an application fee as of March 25, 2011. You must submit an initial application fee to the National Supplier Clearinghouse of $505. NSC is who processes the 855s DME applications and is now returning any applications that do not have this fee included in the enrollment packet.

If you submitted an initial application prior to March 25 and it is returned/rejected, when you resubmit you must include the application fee. I expect that before long they are going to start charging enrollment/application fees for everyone, we have to pay for the government’s bad habits somehow.

Today, 1/31/2011, a federal judge in Pensacola, Florida declared the Healthcare Reform Law unconstitutional.  Specifically, he pointed to the individual mandate requiring citizens to purchase healthcare coverage as unconstitutional and that Congress exceeded the bounds of their authority under the constitution.

You can view the full ruling here:  Federal Judge Declares Healthcare Reform Unconstitutional

Categories : General, Insurance News
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