[NPInfo] Incident to Billing

[Havens, Shelby]

Dear Tracey:

Doesn't "incident to" billing mean more money coming in under the
physician's name? It still renders the NP invisible, with no direct way
to prove our productivity and our worth. We are simply bringing in more
money for the doctor under this arrangement.  

I am an "out of network" provider for BC/BC of Florida. I can't be a
network or preferred provider since I am not a physician. When I was in
a private practice with two psychiatrists and a mental health counselor,
we billed the Blues for my services. Yes, we could get reimbursed at a
higher rate since we had not signed an agreement to accept only a
certain rate for our services, but most of the patients didn't like this
because their co-pay was higher. The majority of them elected to see
providers who were in the network, so that they were responsible for
only a $20.00 co-pay, so we were not able to retain those patients. The
private practice suffered financially as a result.   

There are about 9000 nurse practitioners in Florida, and our NP
organizations and attorneys have not been able to convince the Blues to
contract with us as network providers. We'll see what 2008 brings. 


Best Regards,

Shelby Havens, ARNP 
   

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On
Behalf Of Tracy Klein
Sent: Thursday, January 03, 2008 10:24 PM
To: npinfo at nurse.net
Subject: [NPInfo] Incident to Billing


"Incident to" billing earns plenty of money for the
physician practice. In fact, they get reimbursed at a
higher rate in many states than direct reimbursement.

It just doesnt earn YOU money as the NP. Especially if
you are salaried.

Tracy Klein, WHCNP, FNP
Portland, Oregon







----------------------------------------------------
Actually, he would have a very valid point in Florida.
The largest
 health 
insurance company down here is Blue Cross Blue Shield
of Florida, and
 they 
do not contract with nurse practitioners. Everything
gets billed
 "incidental 
to" the physician's work. A nurse practitioner cannot
earn money for a 
physician's practice under this arrangement.

Best Regards,

Shelby Havens, ARNP
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