I just joined an otolaryngology practice and I am their first PA. I have been in practice for 9 years, but, embarrassingly enough, I have limited knowledge of billing. My previous ortho practice did not share any information about billing and basically, all of my dictations had to say "I am dictating as a scribe on behalf of Dr. Soandso." I had minimal autonomy and had no access to any collections and never had my own clinic. My experience prior to that was working in the ED for a large public university and we never really talked about collections or billing. With this new practice, I will be in clinic (eventually my own clinic time without a physician in the same locale) and I will spend some time first assisting in the OR. The practice is essentially asking how to bill for me, as they have never had a PA. I know the reimbursement is usually 85% for a PA from Medicare and a lot of other carriers. I also know that a lot of practices bill under a physician's name to get the full 100% (incident-to). I will be seeing a mix of new and established patients in clinic, doing a fair amount of procedures, etc. Obviously, the practice wants to make as much money as possible and are asking me specifics on Incident-to, etc. I have read a lot about it and it sounds pretty complicated and specific. Are there any other ways to bill under a physician other than incident-to? I feel it just may be best, to avoid confusion and error, to just bill under my own name for most things....unless I specifically have a doc come in and examine the patient with me. Is this typical or do a lot of PAs still bill under a physician's name? A friend of mine who works in pediatrics just told me that her practice bills under the physician's name for her patients almost exclusively....but I don't really see how that is possible when she is in a separate local from her supervising physician. Am I missing something?
They are sending me to a billing and coding seminar in August, but, we are trying to get some things figured out, as I have started seeing consults in the hospital already (I'm still training in clinics with the docs) and I will be seeing patients autonomously in clinic in the next month or so. The practice has a consultant that they frequently use, but, she seemed a little unaware of the exact rules, too.
Can anyone help me or at least point me in the right direction?