Reimbursement for Nurse practitioners
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Reimbursement Criteria
Documentation
Assessments and measures
Special Requirements
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It is important as PMHNP's to understand the requirements and policies to receive the most reimbursement for the company. Patient Evaluations: Comprehensive assessments to include physical examinations and history (family, social, medical, and mental health). Full diagnostic criteria, ensuring all criteria is assessed to rule out or rule in an appropriate diagnosis. Include the appropriate diagnostics and interpreting them in a timely manner. A full progress note should follow and include a follow-up plan for the patient. CPT codes: Using the right CPT codes is important. The most common codes are 99212, 99213, 99214, 90792. These cover initial assessment and follow-up appointments. While there is a variety of different billing codes for vatious different appointments, these are the most often used. ICD-10: Providing an appropriate ICD-10 code will help the provider with treatment and the patient with medications. It is important to ensure the right ICD-10 code is used. Reference https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57480
Special Considerations: Nurse Practitioners do not get reimbursed at the same rate that Doctors do. This is why it is important to document everything and try to get credit for as much as possible. Telehealth: Use appropriate code for telehealth services. Ensure informed consent, HIPPA, and appropriate documentation is included in the progress noted. It is important to put a blurb about the telemed communication and that the patient consented to telehealth services. Aside from mentioning the appointment being conducted via telehealth, all other documentation is generally the same. Submitting progress notes in a timely manner is important for full reimbursement. Late notes may not qualify for reimbursement at all if past a certain time frame. It is important to read and study the reimbursement rates, codes, and requirements from the insurance companies. Reference https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10199742/
Documentation: Detailed and accurate information is essential for treatment and reimbursement. SOAP (Subjective, Objective, Assessment, and Plan) is a great format to utilize to ensure documentation of all the necessary information. Important diagnostic criteria is necessary to give evidence for your diagnosis used and this should be documented in the note. If therapy services are included, bill for it and use the appropriate CPT code. Document your medical decision making as best you can to protect yourself, the patient, and receive reimbursement. If a patient is a higher level of acuity or complexity, document everything done and bill for that. Document education, plan, therapy, instructions, compliance, labs ordered or interpreted, reviewing outside records. Reference: https://www.nso.com/npclaimreport_documentation
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Reimbursement for Nurse practitioners
Concept Map
Reimbursement Criteria
Documentation
Assessments and measures
Special Requirements
Contextualize your topic with a subtitle
Concept Map
Structure your content
Write an Awesome Headline
Contextualize your topic
An Awesome Title
An Awesome Title
An Awesome Title
Write an Awesome Subtitle
Write an Awesome Subtitle
Write an Awesome Subtitle
Design
Magic
Wow Effect
Creativity
Animation
Interactivity
It is important as PMHNP's to understand the requirements and policies to receive the most reimbursement for the company. Patient Evaluations: Comprehensive assessments to include physical examinations and history (family, social, medical, and mental health). Full diagnostic criteria, ensuring all criteria is assessed to rule out or rule in an appropriate diagnosis. Include the appropriate diagnostics and interpreting them in a timely manner. A full progress note should follow and include a follow-up plan for the patient. CPT codes: Using the right CPT codes is important. The most common codes are 99212, 99213, 99214, 90792. These cover initial assessment and follow-up appointments. While there is a variety of different billing codes for vatious different appointments, these are the most often used. ICD-10: Providing an appropriate ICD-10 code will help the provider with treatment and the patient with medications. It is important to ensure the right ICD-10 code is used. Reference https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57480
Special Considerations: Nurse Practitioners do not get reimbursed at the same rate that Doctors do. This is why it is important to document everything and try to get credit for as much as possible. Telehealth: Use appropriate code for telehealth services. Ensure informed consent, HIPPA, and appropriate documentation is included in the progress noted. It is important to put a blurb about the telemed communication and that the patient consented to telehealth services. Aside from mentioning the appointment being conducted via telehealth, all other documentation is generally the same. Submitting progress notes in a timely manner is important for full reimbursement. Late notes may not qualify for reimbursement at all if past a certain time frame. It is important to read and study the reimbursement rates, codes, and requirements from the insurance companies. Reference https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10199742/
Documentation: Detailed and accurate information is essential for treatment and reimbursement. SOAP (Subjective, Objective, Assessment, and Plan) is a great format to utilize to ensure documentation of all the necessary information. Important diagnostic criteria is necessary to give evidence for your diagnosis used and this should be documented in the note. If therapy services are included, bill for it and use the appropriate CPT code. Document your medical decision making as best you can to protect yourself, the patient, and receive reimbursement. If a patient is a higher level of acuity or complexity, document everything done and bill for that. Document education, plan, therapy, instructions, compliance, labs ordered or interpreted, reviewing outside records. Reference: https://www.nso.com/npclaimreport_documentation
Write a great headline
Visual content is a cross-cutting and universal language, like music. We are able to understand images from millions of years ago, even from other cultures.
Did you know that Genially allows you to share your creation directly, without the need for downloads? Ready for students to visualize it on any device and learn anywhere.
An awesome presentation...
Write a great headline
We are in the era of the digital information explosion. This causes our way of obtaining information to have changed, we have transitioned from traditional reading to a cognitive strategy based on navigation.
Our brain is biologically prepared to learn through visual content. Almost 50% of our brain is involved in processing visual stimuli.
Here you can put a standout title
Pose a question or problem that makes the class think; it is the essential ingredient to maintain their attention. It is usually posed at the beginning of the topic to encourage critical thinking and participation.