Navigating billing for non-credentialed providers can be challenging. Here’s how to ensure compliance and efficiency:
- Bill Under a Supervising Provider: Use a credentialed provider’s credentials (e.g., a supervising physician) until your credentialing is complete. Ensure services align with their scope of practice and payer rules.
- Verify Payer Policies: Confirm each payer’s requirements for non-credentialed providers. Some may allow temporary billing under specific conditions.
- Avoid Credentialing Delays: Start the credentialing process early to minimize reliance on supervising providers.
- Document Thoroughly: Maintain clear records of services and supervising provider involvement to prevent claim denials or audits.
- Use Modifiers Correctly: Apply modifiers like -Q6 (locum tenens) or -SA (nurse practitioners under supervision) as required by payers.
- Monitor Claims: Track claims closely to address rejections promptly and ensure compliance.
- Offer Cash-Based Services: For non-emergency care, consider self-pay options while credentialing is pending.
By following these steps, practice managers and healthcare owners can streamline billing processes and maintain compliance. Always consult payer guidelines and compliance experts for accuracy.