The Hotel was centrally located, in fact it was an easy walk from the hotel to the Parkway. There could not have been an easier place to get to or to stay in Pigeon Forge. The Hotel Staff were truly wonderful from the moment you check in to the moment you check out. They have the customer service thing on...
But when billed as incident-to, Medicare pays at 100% of the physicianâs fee schedule because the visit falls under the physicianâs NPI. The Medicare criteria for incident-to billing are not well understood by most physicians, so we will try to clear up any confusion.
The pharmacy is contacted by the PBM usually to correct claim billing on a single or small number of claims. It is not used for large volumes of claims. Failure to comply with a telephone audit will normally result in the PBM reversing the claim and could lead to a desk or on-site audit. Resources: Your Guide to the On-Site Audit; Audit Loophole in Medicare Part D