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Billing and Financial

Next Reply: Re:APN Billing
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Post APN Billing
Author: makeane
Date: Sep 24, 2008 7:13 pm
In HPNA's "APN Guide to Practice and Business Issues", listed as a requirement for eligibility to bill CMS is: "credentialed at facility or organization". I have been unable to locate the exact reference supporting this in CMS manual.Any additional information regarding this specific regulation would be greatly appreciated, as this would be an arduous process at our institution, that if possible, I would like to avoid.
Thank You,
Mary Anne Keane, CNS
Palliative Care Coordinator
Sky Lakes Medical Center
Klamath Falls, Or
makeane7@charter.net
Replies: order by [Date] [Author] [Subject]
Re:APN Billing (by JulieP on 10/21/2008)
I've checked everywhere on the CMS site and on our local carrier's site and do not find any notation that NPP's need to be credentialed at facility or organziation before they an bill. With that being said I know that none of our NPP's practice unless they have been credentialed by our organization and our hospital partner. If the NPP is working in an office based clinic they are only credentialed by our organization. I would go back to the HPNA and ask them to site specifically where they got this information.I don't doubt that this is likely true, but like you I cannot find it in any CMS documents pertaining to NPP's. Julie Pipke, CPC Reimbursement Manager, Medicine Medical College of Wisconsin

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