# Physician and PA seeing patient



## raidaste (Jul 15, 2014)

My physician is going to start seeing patients along with our PA. They will enter the room together and the PA will type and the physician will examine. Can someone point me in the right direction to find the documentation requirements for this?
There will also be times when the PA does the initial examination and the physician helps the PA out on plan and assessment. I'm at a loss of how to tell them what to document and how and who should be signing the note?
Thanks


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## mhstrauss (Jul 15, 2014)

raidaste said:


> My physician is going to start seeing patients along with our PA. They will enter the room together and the PA will type and the physician will examine. Can someone point me in the right direction to find the documentation requirements for this?
> There will also be times when the PA does the initial examination and the physician helps the PA out on plan and assessment. I'm at a loss of how to tell them what to document and how and who should be signing the note?
> Thanks



In your first example, the PA would be considered a scribe.  CMS does have specific requirements for this; check with your MAC.  I'll include the link for Novitas; it will at least give you an idea of what to look for:

http://www.novitas-solutions.com/we...tentId=00003295&_adf.ctrl-state=xxha1i4wi_148


Your second example would be a "Split/Shared Service".  Here is a link to info regarding that:

http://www.novitas-solutions.com/we...es%2FMedicareJH&_adf.ctrl-state=xxha1i4wi_226


Hope this helps!


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## psomerhalder (Jul 15, 2014)

*Physican /PA working tandem*

I just recently had to research this in detail.  MCR rules say that a PA/NP should not be a scribe.  A scribe is a person that is documenting every word the provider says into documentation.  There are very specific rules for scribes.  The providers I consult for were not happy to hear this but I spent hours researching and it is not accepted by MCR.  

Hope this helps.

Patti S


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## mhstrauss (Jul 16, 2014)

psomerhalder said:


> I just recently had to research this in detail.  MCR rules say that a PA/NP should not be a scribe.  A scribe is a person that is documenting every word the provider says into documentation.  There are very specific rules for scribes.  The providers I consult for were not happy to hear this but I spent hours researching and it is not accepted by MCR.
> 
> Hope this helps.
> 
> Patti S



Patti,

Do you have any articles or links showing this info?  I researched scribes earlier last year, so it has been awhile, but I don't remember coming across anything like this.  Would be great to have it for my files, if you have the info still available.

Thanks!


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## avon4117 (Jul 30, 2014)

The physician assistant needs to be credentialed with medicare because if they are the ones that are documenting it will be billable under the PA.


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## sawhitt (May 11, 2015)

What an absolute waste for the practice to use a physician assistant as a scribe. The PA-C has a license and can be used more productively seeing patients and taking the load off the physician.  

Why not train an MA to scribe?  The overhead of a PA as a scribe is quadruple that of an MA.  Plus malpractice, benefits, etc  DOES NOT MAKE SENSE AT ALL!!!
Susan Whitt, RN, BSN, MSC, PA-C
PRACTICE MANAGER


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