tci Medicare Compliance & Reimbursement - 2006 Issue 39

NPPs: Don't Take Denials Lying Down--Contact CMS Now

Manual misprint leads to missed reimbursement for NPs.If you're seeing denials for nurse practitioners (NPs) in the hospital, you should raise your concerns with the Centers for Medicare & Medicaid Services (CMS).The problem: Some carriers in the Southwest, and possibly elsewhere, are denying claims for NPs in the hospital, says consultant Quinten Buechner with ProActive Consulting in Cumberland, WI. The carriers may also be bundling hospital claims for other non-physician practitioners (NPPs) such as physician assistants, he says.This problem doesn't apply to shared visits, where an NPP bills under the physician's number for part of a...

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