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Hospital outpatient billing in a provider-based setting can be very nuanced and complicated. In provider-based billing, the main provider is the hospital, which in turn is responsible for the ownership and operation of another location to provide additional healthcare services. These hospital outpatient clinics are subject to stricter government regulations because the patients are essentially being treated by the hospital either on campus or off campus. Provider-based billing requires qualified and competent revenue cycle management to ensure that providers are correctly identified and eligible for provider-based status and are also appropriately reimbursed. Provider-based billing models can be tedious and confusing, requiring competent oversight and training to ensure compliance with these stringent Medicare rules. Physician supervision requirements vary depending on the type of services being provided as well as the location of the service.
In this webinar, industry expert Toni Elhoms will discuss the 2025 physician supervision requirements for diagnostic services and therapeutic services, the rules for on-campus vs. off-campus departments, as well as the different types of physician supervision – general, direct, and personal required for each setting.
Navigating Medicare compliance for provider-based billing can be challenging due to the intricate and evolving regulations. This session will clarify the detailed physician supervision requirements for both diagnostic and therapeutic services, highlighting the key distinctions between on-campus and off-campus provider-based departments. Attendees will gain the knowledge needed to confidently address the complexities of compliance in these specialized settings.
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Coders, Auditors, Billers, Educators, Consultants, Health Information Management Professionals, Revenue Cycle Management Professionals, Revenue Integrity, Medical Providers of all specialties, Physician Advisers, Compliance Officers/Committees, Medical Practices, Accountable Care Organizations, Medical Societies, Medical Associations
