RE: Nurse Practitioner - Florida (another question)

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Can a nurse practitioner working for a Medical group *in Florida* be
assigned a PTAN? (I called the carrier in Florida and the answer I got was
a script: "If the application is approved and meets requirements, a PTAN is
assigned for any provider.")



It didn't answer my question as to whether an NP can apply for and be
assigned a PTAN.



In other words, can the group member Nurse Practitioner bill for their own
services through the group to Medicare Part B for 85% of the allowed amount?



(Florida is not an independent practice state and their supervision
requirements are not as tight as Medicare's.)



Karen A. Hurley, BS, CMM, CPC, CNA

President, HPMSI

PO Box 409

Parrish, FL 34219

Tel: (941) 776-4822

Fax: (240) 368-0059

Web: www.hpmsi.com



Since 1996, Celebrating 20 years of Service to Physicians



Disclaimer: Advice or comments given in this email are specific only to the
recipient and the presented issue. It is not intended to be used as a
global solution for future similar events. Reproduction of the information
requires approval by the author.





From: Karen Hurley CMM CPC [mailto:karenhurley@hpmsi.com]
Sent: Sunday, December 18, 2016 6:11 AM
To: Multiple recipients of list PARTB-L
Subject: [partb-l] Nurse Practitioner - Florida



I am hoping John Bishop is still on the list, I need some advice as to
whether my research has been correct. I came from Maryland, where NP's can
be in independent practice. In Florida, they cannot (which makes problem
solving much harder) - but there appears to be some bills that have passed
recently in 2016.



Although the end result of my findings need to be scrutinized by a Florida
health law attorney, I want to see if I am understanding my research so I
can present my findings to support the need for one to the person who
approached me with the business model.



State: Florida

Provider: Chiropractor opening a wellness center, wants to hire a Nurse
Practitioner to see patients.



So far, what I have found is that since the NP cannot practice independently
and be separately credentialed with health plans, incident to is the only
option. However, billing incident to goes under the supervising physician's
name, and from what I can find, a chiropractor cannot do that, it must be an
MD. Florida allows for off-site supervision (which leaves out Medicare
patients in a non-independent state); this means the chiropractor would have
to hire the MD to do that.



I don't believe the chiropractor can hire an MD.



I know from claims construction that billing for the NP's work must be under
the supervising physician's name, and that MD would have to be credentialed
with the group for the claim to process.



In other words, my research has lead me to the point of the person needing
legal advice (chiro hiring MD), but I want to be sure I understand the
Florida NP practice arrangement.





Karen A. Hurley, BS, CMM, CPC, CNA

President, HPMSI

PO Box 409

Parrish, FL 34219-0409

Tel: (941) 776-4822

Fax: (240) 368-0059

Web: www.hpmsi.com



Since 1996, Celebrating 20 years of Service to Physicians



Disclaimer: Advice or comments in this email are specific only to the
recipient and the presented issue. It is not intended to be used as a
global solution for future similar events. Reproduction of the information
requires approval by the author.










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Can a nurse practitioner working for a Medical group =
*in Florida* be assigned a PTAN?  (I called the carrier in =
Florida and the answer I got was a script: “If the application is =
approved and meets requirements, a PTAN is assigned for any =
provider.”)

 

It =
didn’t answer my question as to whether an NP can apply for and be =
assigned a PTAN.

 

In other =
words, can the group member Nurse Practitioner bill for their own =
services through the group to Medicare Part B for 85% of the allowed =
amount?

 

(Florida is not an independent practice state and =
their supervision requirements are not as tight as =
Medicare’s.)

 

Karen A. Hurley, BS, CMM, CPC, =
CNA

President, =
HPMSI

PO Box 409

Parrish, FL 34219

Tel: (941) 776-4822

Fax: (240) 368-0059

Web: www.hpmsi.com

 

Since 1996, Celebrating 20 =
years of Service to Physicians

 

Disclaimer:  Advice or comments given in this email are =
specific only to the recipient and the presented issue.  It is not =
intended to be used as a global solution for future similar =
events.  Reproduction of the information requires approval by the =
author.

 

 

From: Karen Hurley CMM CPC =
[mailto:karenhurley@hpmsi.com]
Sent: Sunday, December 18, =
2016 6:11 AM
To: Multiple recipients of list PARTB-L =
<partb-l@list.partbnews.com>
Subject: [partb-l] Nurse =
Practitioner - Florida

 

I am hoping =
John Bishop is still on the list, I need some advice as to whether my =
research has been correct.  I came from Maryland, where NP’s =
can be in independent practice.  In Florida, they cannot (which =
makes problem solving much harder)  – but there appears to be =
some bills that have passed recently in 2016.

 

Although the =
end result of my findings need to be scrutinized by a Florida health law =
attorney, I want to see if I am understanding my research so I can =
present my findings to support the need for one to the person who =
approached me with the business model.

 

State:  =
Florida

Provider:  Chiropractor =
opening a wellness center, wants to hire a Nurse Practitioner to see =
patients.

 

So far, what I have found is that since the NP cannot =
practice independently and be separately credentialed with health plans, =
incident to is the only option.  However, billing incident to goes =
under the supervising physician’s name, and from what I can find, =
a chiropractor cannot do that, it must be an MD.  Florida allows =
for off-site supervision (which leaves out Medicare patients in a =
non-independent state); this means the chiropractor would have to hire =
the MD to do that. 

 

I =
don’t believe the chiropractor can hire an MD.

 

I know from =
claims construction that billing for the NP’s work must be under =
the supervising physician’s name, and that MD would have to be =
credentialed with the group for the claim to process.

 

In other =
words, my research has lead me to the point of the person needing legal =
advice (chiro hiring MD), but I want to be sure I understand the Florida =
NP practice arrangement.

 

 

Karen A. Hurley, BS, CMM, =
CPC, CNA

President, =
HPMSI

PO Box 409

Parrish, FL  34219-0409

Tel: (941) 776-4822

Fax: (240) 368-0059

Web: www.hpmsi.com

 

Since 1996, Celebrating 20 =
years of Service to Physicians

 

Disclaimer:  =
Advice or comments in this =
email are specific only to the recipient and the presented issue.  =
It is not intended to be used as a global solution for future similar =
events.  Reproduction of the information requires approval by the =
author.

 

 

 

 

 * =
* *Part B-L is sponsored by Part B News (www.partbnews.com), which is =
published by DecisionHealth (http://www.decisionhealth.com)=
. Call us toll-free =
877-602-3835 To =
unsubscribe: Go to http://www.decisionhealth.=
com/partb-l
; Type in your email address; Click “My =
Forums”; Click =
“unsubscribe” Going on vacation? Set your membership to no email. Here’s how: =
http://www.decisionhealth.=
com/partb-l
; Type in your email address; Click “my =
account”; Look for “Membership type” and click the =
arrow next to the box; Select no email; Click “save =
changes”; Click “log =
out.” If you =
belong to more than one of our forums, simply click on one of the forums =
and follow the same directions as above. The selection you make, e.g., =
“no email,” should apply to all of your =
forums. To post to this =
list, use partb-l@list.partbnews.com=

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