NP making six figures? - page 9

Hey all, The general salary figure I hear for NPs disappoints me as I'm sure it disappoints the NPs!! I mean an NP providing primary care which includes prescribing medication, diagnosing... Read More

  1. by   core0
    Quote from caldje
    Please explain how he can bill more for you because you are an NP than he could for a PA...


    p.s. for those who don't know, Im asking this because it is impossible.
    I would second this question. The billing rules for NPs and PAs are identical. Also if you are consulting on your own patients (ie. the MDs surgery patients) as inpatients then you are violating Medicare guidelines. Yes there are ways to make more money billing for NPs than PAs all of them illegal.

    David Carpenter, PA-C
  2. by   NP4KIDS
    Quote from core0
    I would second this question. The billing rules for NPs and PAs are identical. Also if you are consulting on your own patients (ie. the MDs surgery patients) as inpatients then you are violating Medicare guidelines. Yes there are ways to make more money billing for NPs than PAs all of them illegal.

    David Carpenter, PA-C
    Not sure what state you are practicing in, but I have an independent billing number and when I see patients in the clinic and as in-patients we bill under my number. The PA's we previously had working for us were unable to do this, as they were not allowed an independent billing number, and I was told this both from my hospital administration and the PA's I worked with. It is absolutely NOT illegal! I thought this was a web group for nurses, not PA's.
    I would never engage in fraudulent billing, and my hospital system/sponsoring physician would not either. This billing is why having me work with the physician is more beneficial than having a PA-in my state PA's do not have independent billing numbers.
  3. by   core0
    Quote from NP4KIDS
    Not sure what state you are practicing in, but I have an independent billing number and when I see patients in the clinic and as in-patients we bill under my number. The PA's we previously had working for us were unable to do this, as they were not allowed an independent billing number, and I was told this both from my hospital administration and the PA's I worked with. It is absolutely NOT illegal! I thought this was a web group for nurses, not PA's.
    I would never engage in fraudulent billing, and my hospital system/sponsoring physician would not either. This billing is why having me work with the physician is more beneficial than having a PA-in my state PA's do not have independent billing numbers.
    PAs have individual medicare billing numbers (UPIN and provider ID numbers). They also have individual NPIs. By federal law any provider that bills under medicare or medicaid must bill under their provider number unless they are billing incident to or co-billing. The reimbursement for NPPs (CNM, PA, NP, CNS) is the same, 85% of the physician fee.

    In some states Insurers are required to credential and contract with NPs separately for services provided. However, in most cases insurance companies credential the physician and then the practice bills under the physicians provider number for both PAs and NPs.

    While I am sure that your hospital means well, I can show you a number of cases where hospitals intentionally or unintentionally created cases of fraudulent billing - in one case to the tune of $600 million.

    I am not sure exactly which "identification number" you are referring to that does not allow PAs to bill or that only NPs can get "independently". As I explained above, the process for PAs and NPs is identical. The only difference is that Medicare allows NPs to be paid directly without pass through from the physician.

    Yes this is a nursing board. When you post false or misleading information then I feel compelled to answer. As always I am happy to help anyone with billing questions.

    David Carpenter, PA-C
  4. by   HealthyRN
    Quote from core0
    PAs have individual medicare billing numbers (UPIN and provider ID numbers). They also have individual NPIs. By federal law any provider that bills under medicare or medicaid must bill under their provider number unless they are billing incident to or co-billing. The reimbursement for NPPs (CNM, PA, NP, CNS) is the same, 85% of the physician fee.

    In some states Insurers are required to credential and contract with NPs separately for services provided. However, in most cases insurance companies credential the physician and then the practice bills under the physicians provider number for both PAs and NPs.

    While I am sure that your hospital means well, I can show you a number of cases where hospitals intentionally or unintentionally created cases of fraudulent billing - in one case to the tune of $600 million.

    I am not sure exactly which "identification number" you are referring to that does not allow PAs to bill or that only NPs can get "independently". As I explained above, the process for PAs and NPs is identical. The only difference is that Medicare allows NPs to be paid directly without pass through from the physician.

    Yes this is a nursing board. When you post false or misleading information then I feel compelled to answer. As always I am happy to help anyone with billing questions.

    David Carpenter, PA-C
    As always, thank you for your informative post. Yes, this is a nursing board, but everyone is welcome and your contributions add a different perspective to the discussions. Please don't let a poster scare you off!

    In regards to NP4Kids, having an "independent billing number" does not change the reimbursement amount. Coreo explained it quite well.
  5. by   caldje
    I figured Id be better off letting core answer that. I wish I had his political acumen!
  6. by   sirI
    Quote from caldje
    I wish I had his political acumen!
    Me, too.
  7. by   traumaRUs
    Me three - his info is correct to the best of my knowledge.
  8. by   core0
    Quote from traumaRUs
    Me three - his info is correct to the best of my knowledge.
    I have a few advantages. I teach billing courses, I just had to do my credentialling (including moving my NPI to another practice) and since I am now in surgery I have to brush up on surgical billing (a whole different can of worms).

    David Carpenter, PA-C
  9. by   traumaRUs
    I'll take bets you'll do great David - good luck in your new endeavor.
  10. by   core0
    Quote from traumaRUs
    I'll take bets you'll do great David - good luck in your new endeavor.
    They only issue I really have is the pace of the academic environment. In private practice I would already be seeing patients. Here I have a week of orientation, then some more orientation, then wait for credentialling. I'll probably be sitting around for a month or so. Be a good opportunity to finish some papers that just need touch up for publication any way.

    David Carpenter, PA-C
  11. by   traumaRUs
    I had to be credentialled at 7 hospitals total and one took 8 months!!!! Not sure what they were looking for - lol!

    Its so funny - when I was in the military and then again as a civilian working for the military, I had a top secret clearance with complete (and I do mean complete) background check done in two weeks!

    Enjoy your down time.
  12. by   tom t
    Quote from zacarias
    Hey all,

    The general salary figure I hear for NPs disappoints me as I'm sure it disappoints the NPs!! I mean an NP providing primary care which includes prescribing medication, diagnosing medical illness, and paying substantial malpractice insurance and only getting arround $70K is disgusting!
    Is there any place in the country where NPs get paid $100K+? Maybe agency or something? Thanks.
    Yes, I employ 5 family nurse practitioners. Base salary of $85,000 and incentive based on production. They average $125,000 annually and that includes all fringes, insurance etc.
    tomt

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