Unlocking Revenue: Effective Strategies for Incident-to and Split Shared

Course Description

Navigating the complexities of healthcare billing is essential for maximizing revenue and maintaining compliance. This intermediate-level webinar, led by Dawson Ballard Jr, RHIA, CCS-P, CPC, CEMC, CEMA, AAPC Fellow, provides a comprehensive exploration of incident-to and split/shared services—two critical concepts in medical billing and coding. Attendees will gain a clear understanding of the definitions, requirements, and distinctions between incident-to and split/shared services, with a focus on the latest CMS rules and regulatory updates. The session will cover eligible providers and settings, supervision requirements, and the importance of accurate documentation, including tracking time and medical decision making (MDM).

Through real-world scenarios and practical examples, participants will learn how to determine the “substantive portion” for split/shared services and apply appropriate modifiers (FS, FT) to optimize billing. The webinar will also address common compliance mistakes, audit risks, and strategies to avoid denials, ensuring attendees are equipped to maximize reimbursement and operational efficiency. Designed for coders, billers, CDI professionals, revenue cycle specialists, and providers, this training delivers actionable insights and best practices to support compliant, effective billing in today’s evolving healthcare landscape.

Learning Objectives

• Define and distinguish between incident-to and split/shared services, including their unique requirements and billing implications
• Interpret the latest CMS rules and updates for incident-to and split/shared services, focusing on compliance and regulatory changes
• Identify eligible providers and settings for each billing type, such as physicians, non-physician practitioners (NPPs), and various healthcare environments
• Explain supervision requirements for incident-to billing versus split/shared services, and how these impact workflow and compliance
• Demonstrate proper documentation practices to support compliant billing, including tracking time, medical decision making (MDM), and provider roles
• Apply the concept of the “substantive portion” in split/shared services, using time or MDM to determine billing responsibility
• Recognize common compliance mistakes and audit risks and implement strategies to avoid denials and maximize reimbursement
• Utilize real-world scenarios and modifiers (FS, FT) to accurately bill incident-to and split/shared services, optimizing revenue and operational efficiency

Areas Covered in the Session

• Clearly define “incident-to” and “split/shared services,” highlighting the differences in settings, requirements, and billing implications
• Review the latest CMS rules for both incident-to and split/shared services, including the 2024 updates on substantive portion and billing provider
• Explain which providers (physicians, NPPs) and settings (office, hospital, SNF, outpatient) qualify for each billing type
• Detail the supervision needed for incident-to billing (direct supervision in office) versus split/shared services (no direct supervision required in facility)
• Emphasize the importance of thorough documentation, including who performed each part of the service and how time or medical decision making (MDM) is tracked
• Discuss how to determine the “substantive portion” for split/shared services—either more than half of the total time or a substantive part of MDM
• Provide real-world examples and scenarios for billing incident-to and split/shared services, including use of modifiers (FS, FT)
• Identify frequent compliance mistakes, such as billing for new patients under incident-to, and strategies to avoid denials and audit risks
• Explain how billing under the physician’s NPI (incident-to) yields 100% reimbursement, while NPP billing is at 85%, and how split/shared services affect payment
• Share actionable tips for optimizing documentation, supervision, and billing processes to maximize compliant revenue and operational efficiency
• Live Q&A Session

Suggested Attendees

• Physicians
• Physician Assistants
• Nurse Practitioners
• Certified Nurse Midwives
• Providers
• Medical Coders
• Medical Billers
• CDI Professionals
• Compliance Officers
• Revenue Cycle Professionals
• Revenue Cycle Staff
• Practice Managers
• Hospital Administrators

About the Presenter

Dawson Ballard Jr. is a healthcare coding expert and educator with over 20 years of experience in medical coding, auditing, and education. He specializes in CPT, ICD-10-CM, and HCPCS coding across a variety of specialties, including OBGYN, family practice, and internal medicine. Dawson has held positions such as Coding Auditor & Educator at Rush University Medical Center, Audit & Compliance Specialist at LMH Health, and Risk Adjustment Coding Auditor at Blue Cross and Blue Shield of Kansas City. He holds multiple industry credentials, including Registered Health Information Administrator (RHIA), Certified Coding Specialist – Physician Based (CCS-P), Certified Professional Coder (CPC), and Certified Professional Medical Auditor (CPMA). Dawson is recognized as an AAPC Fellow and actively contributes to professional associations, having served as a local chapter officer, speaker, and published author on medical coding topics.

Additional Information:

After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.

System Requirement:

• Internet Speed: Preferably above 1 MBPS
• Headset: Any decent headset and microphone which can be used to talk and hear clearly

Live Course Cancellation Policy: If for any reason Skillacquire need to cancel this program, Skillacquire will notify participants by email of the cancellation no less than 24 hours prior to the expected start time.

Can’t Listen Live?

No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact:

Toll-Free No: 1-302-444-0162

Email: care@skillacquire.com

Address:- 651 N. Broad Street, Suite 206, Middletown, DE 19709

Testimonials:

"This program on HIPAA did a great job providing actionable concepts in a way that updated our team and me, I now know how I will implement the concepts because I already did it in their online seminar, it was easy to ask questions from the speaker at the end of my 60 minutes course"

Melissa Preston, Health Information Management Staff"David Vaughn covered the material completely and I have a new understanding of when, where and why we need to use an ABN"

Sandie Fowler, Out of Network Billing Staff"Great presentation. Able to do during the day. Timing was great"

Tina Duffy, Compliance Officer

All tickets include recording of the event.