first covering how a change in \u201cincident-to\u201d billing could specifically impact social workers who provide outpatient mental health counseling in Michigan<\/a>. <\/p>\nAfter publishing the first story, several viewers reached out, saying this would also impact nurse practitioners who work in psychiatric offices. <\/p>\n
\u201cWith incident-to billing, clinics are going to be forced to transfer care from nurse practitioners to psychiatrists,\u201d Emily Williams, the chief operating officer at Serenity Bay Health said. <\/p>\n
\u201cWith the policy that will be starting in March, when the nurse practitioner sees those patients, reimbursement will only be at 80%,\u201d Williams said. <\/p>\n
Experts say \u201cincident-to\u201d billing has been the standard for private practices in Michigan for years. <\/p>\n
In this case, it allows psychiatrists to sign off on nurse practitioners helping with patient care, meaning the work done by a nurse practitioner is billed under their supervisor.<\/p>\n
\u201cThere are many more nurse practitioners than there are psychiatrists,\u201d Williams said. \u201cSo, the access to care will be decreased.\u201d<\/p>\n
Because of the move, Williams says staff like hers will have to make changes. She says studies say psychiatry is already a severely understaffed specialty.<\/p>\n
\u201cOur office has 2 psychiatrists and we have 8 nurse practitioners,\u201d she said. \u201cOur psychiatrists mostly see the new patients. They provide them with diagnoses and they set up the treatment plan. In order to continue to see new patients and provide care, they have to pass those patients on to nurse practitioners who can follow up with them on a monthly basis, or more frequently.\u201d<\/p>\n
Williams also says there could be a trickle down impact when individuals who can\u2019t get into an office end up in the emergency room for help. She worries the reality will also stretch current psychiatrists too thin.<\/p>\n
Local 4 reached out to BCBSM. <\/p>\n
\u201cIn service to our members, Blue Cross Blue Shield of Michigan reviews our payment policies on a regular basis to ensure they reflect the most up-to-date guidance and data,\u201d they say. \u201cThis change requires providers to file claims under their own National Provider Identifier. This ensures that providers such as nurse practitioners and physician assistants bill for their services directly, rather than billing through the supervising physician. This will allow them to participate more directly in Blue Cross\u2019 incentive and value-based programs that are at the forefront of our patient-centered care efforts. It also ensures services are delivered by appropriately qualified providers and aligns our policy between Blue Cross and Blue Care Network commercial health plans.\u201d<\/p>\n
Local 4 asked Williams what she\u2019d say to the insurance company. <\/p>\n
\u201cRight now, it can take up to two months to see a psychiatrist,\u201d she said. \u201cMake these policy changes and see how much longer that becomes.\u201d<\/p>\n
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