Shadow Billing definition
Shadow Billing means the process where physicians receiving alternate payment submit specially designated claims for the medical services provided to patients that result in no payment, subject to the blended payment where applicable.
Shadow Billing means reporting by Physicians of Insured Medical Service encounter information to MSI in the format prescribed by DOH;
Examples of Shadow Billing in a sentence
Any Physician receiving Alternate Payment who fails to provide Shadow Billing may be required to convert to fee-for-service at the discretion of Health PEI in those circumstances.
All Physicians receiving Alternate Payment shall perform Shadow Billing.
For clarity, despite the provisions of the EDAFA, Second On-Call Physicians (as defined in the EDAFA) providing on-site services under the EDAFA shall prepare Service Encounter Reports (Shadow Billing) and be paid at their site’s hourly rate within the 120% funding provided, together with the applicable shadow billing premium, rather than being compensated entirely on a fee-for-service basis.