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Vital Information on NP Billing

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Billing Physician Services Provided by Nurse Practitioners in Specialists' Offices, Hospitals, Nursing Facilities, Homes and Hospice. Carolyn Buppert, NP, JD. 2004. $89, 173 pages, Law Office of Carolyn Buppert, 443-482-3360 or www.buppert.com.

Reviewed by Lynn Price, NP, JD, associate professor in the graduate nursing program at Quinnipiac University in Hamden, Conn.

Carolyn Buppert's latest book provides an amenable guide to complexities involved with NP billing. Published in a paperback workbook format, the book summarizes various rules governing billing and provides information about where to find these rules. This alone makes the book a valuable resource for NPs, practice managers and billing departments.

Buppert also briefly analyzes rules by practice setting, which is particularly useful for NPs working in arenas other than primary care. Separate chapters for hospice, home care, hospitals, specialty offices and nursing facilities address specific billing requirements for each setting and billing questions that typically arise in these environments.

The last two chapters cover prevention: how to preclude fraud investigations and audits and how to minimize claim denials. Most prevention strategy is common sense, but Buppert's recommendations provide a reminder of best billing practices. The chapters also explain how government authorities learn of potential billing abuse and fraud and how investigations unfold. Understanding this may help NPs and their colleagues face billing issues more rationally.

Various appendices make up 50% of the book and summarize statutory NP authority and portions of Medicare regulations and advisory statements. Since these documents can be cumbersome to locate in carrier manuals or the Federal Register, the compendium is a welcome addition to the reimbursement library and may justify the steep price of the book.

Because of continuing changes in state statutes, perhaps future editions could direct NPs to check statutory authority directly. State statutes can be easily accessed online.

Overall, the book offers vital NP billing information. Given the amount of misinformation in the field, Billing Physician Services Provided by Nurse Practitioners is an important and useful supplement to billing guidance and best practice.




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