Navigating Physician Supervision Rules for Provider-Based Clinics: A Comprehensive Guide

Hospital outpatient billing in a provider-based setting can be highly detailed and intricate. In a provider-based billing model, the main provider is the hospital, which is responsible for the ownership and operation of an additional location to deliver further healthcare services. These hospital outpatient clinics are subject to stricter government regulations, as patients are considered to be under the care of the hospital, whether on-campus or off-campus.

Provider-based billing requires skilled revenue cycle management to ensure accurate provider identification, eligibility for provider-based status, and proper reimbursement. The complexities of this billing model necessitate thorough oversight and training to ensure compliance with stringent Medicare rules. Physician supervision requirements differ based on the type of service provided and the service location.

This webinar, led by industry expert Toni Elhoms, will cover the physician supervision requirements for diagnostic and therapeutic services, rules for on-campus versus off-campus departments, and the various types of physician supervision—general, direct, and personal—required in each setting.

Webinar Objectives

This session is designed to provide attendees with a comprehensive understanding of the complexities involved in hospital outpatient billing in a provider-based setting. Participants will gain insight into the nuanced regulatory requirements, focusing particularly on the strict Medicare rules governing provider-based billing. The webinar will delve into critical aspects of revenue cycle management, including accurate provider identification, eligibility for provider-based status, and ensuring proper reimbursement.

Additionally, the session will explore the different physician supervision requirements depending on the type of services provided and the location, clarifying the distinctions between general, direct, and personal supervision. By the end of the webinar, participants will be equipped with the knowledge needed to navigate the intricacies of provider-based billing, ensuring compliance and optimal revenue management.

Webinar Agenda

• Review regulatory requirements for provider-based billing status.
• Outline the different types of physician supervision requirements for provider-based billing.
• Discuss specific physician supervision requirements for diagnostic and therapeutic services within provider-based billing.
• Identify physician supervision requirements for both on-campus and off-campus hospital departments in provider-based billing.
• Review common scenarios for each setting type in provider-based billing.

Webinar Highlights

• Gain insight into the various types of physician supervision requirements applicable to provider-based billing.
• Recall specific physician supervision requirements for diagnostic services within provider-based billing.
• Recognize the physician supervision requirements for therapeutic services in provider-based billing.
• Recall the physician supervision requirements for both on-campus and off-campus hospital departments within provider-based billing.
• Recognize common scenarios encountered in each setting type within provider-based billing.

Who Should Attend

Coders, Auditors, Billers, Educators, Consultants, Health Information Management Professionals, Revenue Cycle Management Professionals, Revenue Integrity Specialists, Medical Providers of all specialties, Physician Advisers, Compliance Officers/Committees, Medical Practices, Accountable Care Organizations, Medical Societies, Medical Associations.