[NP-Clinical] Re: Billing awareness

[Marilyn Dean]

Tracy,
Iowa is also an independent practice state, but I choose to practice with 2
physicians and we now have another nurse practitioner. All four of us get a
detailed list of charges, levels of care charged, write offs, and amount
collected for each of us. I know how much lab in dollars I order, how many
DXA scans I do. Obviously this explains a lot to me and is important for me
to understand my bonus calculation. I have chosen to stay with my original
base pay of 8 years ago and it has been fun to see my practice grow, as well
as my bonus. I bill everything I can under my own numbers, do have hospital
privileges that require a lot more co-signatures from physician and have
chosen not to do hospital, in part because of this and also I am plenty busy
and don't need the night hassles, etc. I use my physician's as hospitalists
when someone needs to be admitted. I hope that helps you with the clinic
side of things.
Marilyn Dean

-----Original Message-----
From: np-clinical-bounces at nurse.net
[mailto:np-clinical-bounces at nurse.net]On Behalf Of Tracy Klein
Sent: Saturday, January 20, 2007 9:50 AM
To: np-clinical at nurse.net
Subject: [NP-Clinical] Re: Billing awareness


I have a question for those of you who are working in
a group or physician practice. Are you aware of the
cost of each of the services you provide? Do you
receive a monthly statement of billings under your
name, or are services billed under the physician name
and number? If you do rounds, how is the practice
billing your hospital services?

This is of interest to me because I am trying to
understand what I am seeing in practice (Oregon is an
independent practice state) which is that most NPs
don't have access to this information and are still
not using their own UPIN or billing numbers. In
addition, it appears that hospitals/practices are
billing inpatient visits "incident to" the physician,
which is not legal under Medicare requirements. Are
there insurance plans which permit this?

This is a huge profit area for MDs, and I am hearing
about NPs working like this in Oregon for 32.00 an
hour!!! I can only assume that they have no knowledge
of what is being billed in their name or how much the
practice is bringing in. Thoughts and feedback
appreciated. If you are in a state which requires
physician collaboration/supervision I'd also like to
know how your compensation works and how you track
what is coming in under your labor.

Thanks!
Tracy Klein, WHCNP, FNP
Portland, Oregon
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