tci Medicare Compliance & Reimbursement - 2015 Issue 2
Compliance: Successfully Navigate the Minefield of Specialist Payment Arrangements
Keep your claims clean and compliant. If you bill for a service and pay part of the collected amount to another provider, you need to steer clear of Stark violations and claim errors. Here’s how to make appropriate use of modifier 26. Scenario: You work for an otolaryngologist who has an agreement for a radiologist to read CT scans performed with your in-office CT scanner. The radiologist doesn’t want to bill for the service, so your physician agrees on an amount to pay him for each read, interpretation, and report. Keep Stark rules and other factors in...
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