This reference covers a wide range of coding billing, and reimbursement issues associated with billing professional services provided by hospital-based physicians. Understanding the differences in billing requirements for the professional and facility components is critical to revenue cycle management. This comprehensive resource provides the guidance necessary to effectively manage billing and collecting for hospital–based physician services.
Features & Benefits:
- Professional Provider Services Reporting Guidelines and Tips. Accurately bill professional charges in the following areas: ER physicians, EKG readings, pathologists, medical nutrition consulting, diabetic self-management staff, CRNAs and hospitals.
- Enrolling with Payer Guide. Find out how to enroll the professional as a part of the hospital professional group.
- Ingenix Edge ¾Coding and documentation Tips. Source documentation and coding tips for both facility and professional components covering each code set and type of service are presented.
- Type of Clinic Guide. Determining provider-based status under CMS regulations is critical for establishing the strategies for appropriate reporting and reimbursement methodology for the facility.
- Billing Formats. Reference billing instructions for completing the CMS-1500 and its electronic equivalent.
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