OIG targeting incident-to billing


In the midst of healthcare reform debates and new HIPAA mandates, the Office of the Inspector General (OIG) has released a new study* of 'incident to' billing.  This study found that unqualified staff rendered 21% of all procedures and services. Specialties at greatest risk include:

ᄋ Ophthalmology

ᄋ Physical medicine and rehabilitation

ᄋ Orthopaedics, particularly those practices that provide physical therapy

ᄋ Cardiology

ᄋ Radiology

ᄋ Any practice that provides diagnostic imaging

ᄋ Any practice that uses nonphysician staff to provide E&M services

As a result of this August 2009 study, OIG and CMS will be working together to scrutinize nonphysician billing and to establish new credentialing guidelines for nonphysician providers.

The Medical Group Management Association is holding a seminar on this subject on September 22nd; click here for more details:


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