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 22^nd; click here for more details:

http://www.mgma.com/solutions/landing.aspx?cid=22714&id1=30187&mid=30187&kc=GAMC

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.