Advanced Practice

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    HANDBOOK FOR ADVANCED PRACTICE NURSES CHAPTER N–200Policy and Procedures for AdvancedPractice Nurse Services Illinois Department of Public Aid  Handbook for Advanced Practice Nurse Services Chapter N-200 - Policy and Procedures January 2002  IDPA N-200 (ii) CHAPTER N-200ADVANCED PRACTICE NURSE SERVICESTABLE OF CONTENTS FOREWORDPURPOSEN-200 BASIC PROVISIONSN-201PROVIDER PARTICIPATION  .1Participation Requirements .2Participation Approval .3Participation Denial .4Provider File Maintenance N-202ADVANCED PRACTICE NURSE REIMBURSEMENT  .1Charges .2Electronic Claims Submittal .3Claim Preparation and Submittal .4Payment N-203COVERED SERVICES  .1Delivery Services .2Certified Family and Pediatric Nurse Practitioner (CFNP and CPNP) .3Certified Registered Nurse Anesthetist (CRNA) N-204   NON-COVERED SERVICESN-205RECORD REQUIREMENTSN-206WRITTEN PRACTICE AGREEMENT GUIDELINES  .1CFNP, CPNP and CNM Written Collaborative Agreement .2CRNA Written Practice Agreement .3APN Employed by a Group Practice .4APN Employed by a Hospital  Handbook for Advanced Practice Nurse Services Chapter N-200 - Policy and Procedures January 2002  IDPA N-200 (ii)  .5Notification to the Department .6Prescriptive Authority N-210GENERAL LIMITATIONS AND CONSIDERATIONS ON COVEREDMEDICAL DIAGNOSTIC AND TREATMENT SERVICES  .1Responsibilities for Services .2Duplicate Payments N-222 MEDICAL DIAGNOSTIC AND TREATMENT SERVICE  .1Laboratory Tests N-240 MATERNAL AND CHILD HEALTH PROGRAM    Handbook for Advanced Practice Nurse Services Chapter N-200 - Policy and Procedures January 2002  IDPA N-200 (iii) FOREWORD PURPOSE This handbook has been prepared to provide information and guidance of advancedpractice nurses (APNs) who provide medical services and covered preventiveservices to participants in the Department’s Medical Programs. Coverage of APNsfor participation was enabled by Omnibus Budget Reconciliation Act of 1987 (OBRA) legislation for the purpose of improving access to primary medical care for children and pregnant women. Included as APN providers are Certified NurseMidwives (CNM), Certified Family Nurse Practitioners (CFNP), Certified PediatricNurse Practitioners (CPNP) and Certified Registered Nurse Anesthetists (CRNA). The handbook is designed to provide specific policy guidelines applicable to APNs. The handbook includes information on provider eligibility criteria, covered services,reimbursement methodology, and billing instructions. It is important that both the provider of service and the provider’s billing personnelread all materials prior to initiating services to ensure a thorough understanding of the Department’s Medical Programs policy and billing procedures. Revisions in andsupplements to the handbook will be released from time to time as operatingexperience and state or federal regulations require policy and procedure changes inthe Department’s Medical Programs. The updates will be posted to theDepartment’s web site at 
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