Integrated Private Practice
Jordan Saint John and Stephen D . Bittinger billing , resulting in reimbursement at the doctor ’ s rather than the mid-level ’ s rate if the physician is onsite , directly in contact with the patients during administration of services , and in compliance with a number of other key requirements . Understanding the difference between just being a supervising physician for state law oversight of a mid-level and proper administration of " incident to " billing can mean the difference between a clean , successful integrated practice and a potentially devastating end to a physician ’ s career .
Conclusion
This article is meant only to provide broad caution and to affirm that integrated practices can operate legally and successfully in every state to some degree . However , careful due diligence and proper legal counsel are essential in the complex and budding arena of integrated practice .
meet the authors :
Stephen Bittinger
Attorney at BITTINGER | LAW , LLC
Stephen is honored to have been able to develop a national reputation for his work in healthcare audit defense , payer appeals , and compliance . His audit defense and payer appeals team has had tremendous success in reducing exposure , swiftly developing corrective action , and successfully appealing Medicare , Medicaid , and major payer recoupment claims . Stephen ' s compliance team focuses on the growing legal arena of compliantly forming and developing integrated and multidiscipline private medical practices . In addition to his healthcare practice , Stephen continues to enjoy working with numerous businesses as general counsel and in litigation . As an adoptive father , he also finds great satisfaction in representing adoption agencies in regulatory and litigation matters and individuals in private and stepparent adoptions .
Takeaways
• Healthcare is becoming increasingly integrated , and the American healthcare consumer expects convenience and a wide array of options in making healthcare choices .
• Integrated practices are attractive to both physicians and non-physicians because of the benefits to patients and financial incentives .
• Integrated practices are not illegal , but significant care must be exercised to structure them in compliance with state law and professional licensing boards .
• The potential pitfalls of integrated practices multiply if federal healthcare program beneficiaries are served .
• Integrated practice is inevitable , and all providers should educate themselves on the opportunities and risks to come .
8 31 U . S . C . §§ 3729 – 3733 .
9 Codified at 42 U . S . C . § 1395nn .
Jordan Saint John
Attorney at BITTINGER | LAW , LLC
As a biomedical engineer , Jordan helped develop a voice-activated environment control system for quadriplegics for the Veterans Administration . In law school , she clerked for the chief appellate judge who was the three-time opinion writer on the Terry Schiavo case . She also interned at the Moffit Cancer Center , a nationally-known cancer research and treatment facility . After her bar admission in Colorado , she associated with a personal injury litigator , then developed a solo practice researching and writing for other attorneys . She now brings her life-long passion for the medical field and her skills as a legal analyst and writer to the Healthcare Team at BITTINGER | LAW .
Before joining BITTINGER | LAW ' s Healthcare Team , Jordan worked in a busy law office , primarily handling personal injury and bankruptcy cases . She was known for her attention to detail as well as her compassionate , personal touch in advocating for her clients . She has written numerous , successful motions and appellate briefs for family law attorneys and civil litigators . Jordan ' s legal analysis and writing has contributed to BITTING- ER | LAW ' S creative advocacy strategies and numerous successes in appealing claim denials by Medicare , Medicaid , and large healthcare insurers . Jordan prides herself on her thorough research , polished writing , and outside-the-box perspective .
TODAY ’ S PRACTICE : CHANGING THE BUSINESS OF MEDICINE 26