Accountable Productivity Performance (APP) Billing Algorithm


Accountable Productivity Performance (APP) Billing Algorithm


Technology: The work is a novel advanced practice provider billing algorithm that provides a standardized compliant process using Medicare guidelines. The algorithm is interchangeable and can be utilized by any health care system to implement standardized APP billing.


Overview: Rapid changes in healthcare are driving the adjustment of work flow by which providers serve patients in team-based care. Specifically, there is a need to develop more effective and efficient utilization with accurate attribution of advanced practice providers’ (APPs) productivity. Through an internal consult service, the Directors of the APP-Best Practice Center conducted assessments of each clinical area and identified a knowledge gap existed, not only regarding billing practices of the APPs (NPs/PAs), but also in the utilization of APPs to practice to the fullest extent of their license, education and experience. By substantiating APPs contribution margin through the process of implementing a new standardized APP billing algorithm, a change in practice was accepted by senior leadership and a new APP Billing algorithm was built while following updated practice laws, compliance/legal standards and hospital bylaws/regulations. Outcomes were evaluated 12 months post implementation. This project uncovered the work already performed by APPs while increasing RVUs, collections and overall patient encounters by the APP/physician team. Findings suggest improved utilization and appropriate attribution of productivity.


Applications: Implementation of standardized APP billing

Advantages: Novel APP billing algorithm

Key Words: Advanced Practice Provider, APP, billing, Medicare


Publication: Brooks, Paula B., and Megan E. Fulton. "Demonstrating advanced practice provider value: Implementing a new advanced practice provider billing algorithm." Journal of the American Association of Nurse Practitioners 31.2 (2019): 93-103.


Inventors: Paula Brooks, DNP, FNP-BC, MBA, RNFA & Megan Fulton, MSPAS, PA-C       

MUSC-FRD Technology ID: P1903


Patent Information:
For Information, Contact:
zzFRD Admin/Archive
MUSC Foundation for Research Development
Paula Brooks
Megan Fulton
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