Tertiary nurse practitioner reimbursement: An in-depth look at neonatal nurse practitioner billing

This report reviews the history of nurse practitioner reimbursement legislation specifically as it pertains to neonatal nurse practitioners (NNPs) in the tertiary care setting (inpatient/acute care). Barriers to reimbursement are reviewed, along with ways in which NNPs can continue to demonstrate their worth to the public and to health insurance providers. Specific steps are discussed on how hospital and health care providers are reimbursed for services rendered; obtaining a billing provider number is the initial step of establishing a billing service. Each state varies on how provider numbers are obtained and who is eligible to receive these numbers. Care must be taken to ensure that duplicate billing by different providers is avoided. The state's Medicaid Provider Manual is often helpful in determining which services are covered and which guidelines accompany each billable code. As tertiary care and/or follow-up providers, it is our responsibility to educate ourselves about the nurse practitioner reimbursement laws currently in effect and educate our legislators about our critical role in providing care to the sick inpatient population. Copyright © 2001 by W.B. Saunders Company