by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Feb 5th, 2019
State scope of practice laws and regulations will help determine who is considered clinical staff and who is considered an other qualified healthcare professional.
Examples of other qualified healthcare professionals:
- Nurse Practitioner (NP)
- Certified Nurse Specialist (CNS)
- Physician Assistant (PA)
- Certified Nurse Midwife (CNM)
- Certified Registered Nurse Anesthetist (CRNA)
- Licensed Clinical Social Worker (LCSW)
- Physical Therapist (PT)
(NOTE: this list is not all-inclusive, please refer to your payer with more specific questions)
Clinical staff are staff members who would generally work under the supervision of a physician or perhaps another qualified health care professional. Clinical staff must be allowed, by regulation, law, and the policy of the facility, to perform or assist and will not report their service. (This is not
CMS clarifies Clinical Staff in their FAQs. Read the entire article here.
AAPC also has an article that defines a Qualified Healthcare Professional.
Read AMA's Physician Assistant scope of practice at the state level.
References/Resources
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller currently employed with Find-A-Code. Bringing over 30 years of insight, business knowledge, and innovation to the healthcare industry. Establishing a successful Medical Billing Company from 1994 to 2015, during this time, Christine has had the opportunity to learn all aspects of revenue cycle management while working with independent practitioners and in clinic settings. Christine was a VAR for AltaPoint EHR software sales, along with management positions and medical practice consulting. Understanding the complete patient engagement cycle and developing efficient processes to coordinate teams ensuring best practice standards in healthcare. Working with payers on coding and interpreting ACA policies according to state benchmarks and insurance filings and implementing company procedures and policies to coordinate teams and payer benefits.
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