Shannon DeConda, CPC, CPC-I, CEMC, CMSCS, CPMA®
Announced in June by UnitedHealthcare (UHC), its new policy begs the question: “Are you adding the modifier correctly for UHC services for your qualified healthcare professional?” Below is the policy:
New Policy – Advanced Practice Health Care Professional Evaluation and Management Procedures Policy
Effective for claims with dates of service on or after Sept. 1, 2017, UnitedHealthcare will require physicians reporting evaluation and management (E/M) services on behalf of their employed Advanced Practice Health Care Professionals to report the services with a modifier to denote the services were provided in collaboration with a physician. UnitedHealthcare will accept the modifier SA on claims for these services when provided by nurse practitioners, physician assistants, and clinical nurse specialists.
This coming Monday, during the next edition of Monitor Mondays, special guest Shannon DeConda, founder and president of the National Alliance of Medical Auditing Specialists (NAMAS), will report on how this policy will affect your claims.
The broadcast rundown also will include:
Register now for this special news broadcast coming your way on Monday, Sept. 25, 2017 at 10 a.m. ET.
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PROGRAM NOTE: Dedicated physicians need their evaluation and management (E/M) services accurately coded and documented in order to ward off investigations by the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) and audits from third-party auditors. Coming soon will be an exclusive RACmonitor four-part, on-demand series on E&M that can help you protect your facility and physicians. Register now on the RAC University bookstore.
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