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Essay On Reimbursement

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Reimbursement
Reimbursement for services may differ for NPs depending on the restriction of services they can provide as outlined by their state’s practice laws (Kaiser Family Foundation, 2011). Credentialing and payment that is managed by many health plans provide payment according to the services that an NP can provide in each state, or from a federal perspective, Medicare will only pay 85% of the full physician rate to a billing NP or Physicians’ Assistant (PA). This is because the laws are not unified throughout all 50 states (Cassidy, 2012). Many NPs do not feel that this payment model it fair for several reasons (S. S. Gordner, personal communication, July 13, 2016). First, there are many states that allow NPs full practice rights without supervision, they provide the same work and quality as a physician, yet they are paid less as stated above. If the same services are billed under the supervising physician’s national provider identifier (NPI), full reimbursement is paid, but the NP does not get any credit for patient’s care or outcomes (S. S. Gordner, personal communication, July 13, 2016). The second reason is that studies have shown that care provided by NPs can increase the quality of the care that is delivered to patients as well as increased satisfaction in their primary care that is often preferred over …show more content…

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