Navigating the Nuances: Incident-To and Split/Shared E/M Billing Strategies
Course Description:
This webinar is designed to help healthcare providers and administrators navigate the complexities of CMS incident-to and split/ shared billing guidelines. These billing scenarios often cause confusion, leading to compliance risks and lost revenue. In this session, industry experts will break down the rules, clarify documentation requirements, and provide actionable strategies to ensure accurate billing and compliance. Whether you’re new to these concepts or seeking a refresher, this webinar will equip you with the tools to streamline your approach and optimize your practice.
Learning Objectives:
- Understand the fundamental principles and differences between incident-to and split/ shared billing
- Identify key compliance requirements for documentation, supervision, and billing under both guidelines
- Analyze real-world scenarios to determine appropriate billing practices for incident-to and split/ shared services
- Implement practical strategies to avoid common pitfalls and mitigate compliance risks
- Optimize compliant reimbursement and operational efficiency while maintaining regulatory compliance
Areas Covered in the Session:
- Introduction to ‘Incident-To’ and Split/ Shared Billing
- Definition and key differences between incident-to and split/ shared billing
- Importance of compliance with CMS and payer guidelines
- Common misconceptions and challenges in these billing scenarios
- Incident-To Billing Guidelines
- Understanding the “direct supervision” requirement
- Eligible services and providers for incident-to billing
- Documentation requirements to support incident-to claims
- Billing under the supervising provider’s National Provider Identifier (NPI)
- Split/ Shared Billing Guidelines
- Definition and application in facility settings
- Determining when a service qualifies as split/ shared
- Required documentation for split/ shared services
- Billing under the physician’s or advanced practice provider’s NPI
- Comparison of Incident-To vs. Split/ Shared
- Key differences in requirements, documentation, and billing processes
- Scenarios illustrating when to use each billing method
- Common Challenges and Compliance Risks
- Misunderstandings about supervision and documentation
- Frequent audit findings and how to address them
- Strategies to avoid denied claims and mitigate compliance risks
- Real-World Case Studies and Best Practices
- Examples of compliant incident-to and split/ shared billing
- Tips for optimizing documentation workflows
- Implementing policies and training for staff to ensure compliance
- Live Q&A Session
Suggested Attendees:
- Physicians
- Physician Assistants
- Nurse Practitioners
- Certified Nurse Midwives
- Medical Coders
- Medical Billers
- Compliance Officers
- Hospital Administrators
- Practice Managers
- Revenue Cycle Staff
About the Presenter:
Pam D’Apuzzo, CPC, ACS‑EM, ACS‑MS, CPMA, is a Managing Director at VMG Health leading the Coding, Compliance, and Operational Excellence Management service line. She is a recognized leader and industry expert in coding and compliance. Pam’s 30-plus years of healthcare consulting experience spans academic medical centers, community hospitals, faculty practice plans, and large private practices.
A trusted adviser to New York’s leading healthcare institutions, she conducts educational and training seminars and provides comprehensive compliance programs. Pam also has a successful record of practice management services including operational and billing review, practice assessment, practice start-up assistance, and EMR implementation.
Pam is a frequent speaker at conferences sponsored by the American Academy of Professional Coders (AAPC), Health Financial Management Association (HFMA), New England Healthcare Internal Auditors (NEHIA), California Health Information Society (CHIA), New York State Society of Physician Assistants (NYSSPA), Suffolk County Medical Society (SCMS), and American Association of Gynecologic Laparoscopists (AAGL).
Additional Information:
After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.
System Requirement:
- Internet Speed: Preferably above 1 MBPS
- Headset: Any decent headset and microphone which can be used to talk and hear clearly
Can’t Listen Live?
No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com
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"Great presentation. Able to do during the day. Timing was great"
Tina Duffy, Compliance Officer