Creating 'Incident To' A.K.A Intern Claims
When a provider who is not yet credentialed under a particular insurance company joins a group practice, there is often a desire for the group to be able to bill insurance for this non-credentialed provider’s work. And in order to do so, it may be tempting for the group to send the claim for services as an ‘incident to’ claim, where the supervising provider’s NPI number is listed as the rendering provider’s NPI instead of the NPI number of the yet-to-be-credentialed provider.
While TherapyAppointment can help you easily create ‘incident to’ claims for a particular insurance company and set up clinical supervision, be aware that the practice of billing ‘incident to’ may not be allowed by all insurance companies and that an insurance company could even consider it a fraudulent practice that is punishable by hefty fines! It is your responsibility to ensure that your insurance contracts allow the practice.
Setting up Incident To A.K.A. ‘Intern Claims'
Role Required: Owner or Manager Role
To begin, an owner or manager role must go to: Practice Settings and select the Billing and Insurance Tab
Scroll down the Page and Identify the Section: Insurance Features > Choose: Select Manage Companies
Identify the insurance company that you wish to change the setting on and Click on top of the Insurance Company Name to open the screen that enables editing.
Scroll to the very bottom of the page and look for the header Therapist Claim Options. Select the Name of the Supervisee and press the Claim Settings Button.
Scroll down the page to the item ‘Create Intern Claim” and use the dropdown selector to choose the name of the providers name who will go on a claim instead of the supervisees.
Save Your change.
After this change, the Selected Supervisor’s NPI number will be listed as the Rendering Provider of the service whenever this supervisee provides services to a patient with this insurance company.