# Shared/split visits for inpatients



## Texmexsop1 (Oct 14, 2010)

If both the NP and physician see patient on same day and both have face-to-face contact, as long as there is documentation showing each provider's involvement (separate doc), the visit can be shared (and billed under either the NP or the doctor). Correct?
According to CMS, “A summary statement such as ‘seen and examined' or ‘discussed and agree' is not sufficient to describe the physician's involvement.” 
I am having a lot of push back from the doctors who don't want to document their portion. What is everyone else doing?


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## jettagirlfl (Oct 14, 2010)

This is a tricky situation. I am going through the same thing as you are.

Well here it goes; When a pt has Regular Medicare; as long as the attending DR says i have seen & examing the pt, then you can split/share. If the attending does not state that, then you must give all credit to the pa or nurse practioner.

As for Medicare HMO's, the dr must state that, or you cannot bill the visit at all under the pa or nurse practioner. Hope this helps!!! Good Luck!!


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## Texmexsop1 (Oct 14, 2010)

Thanks for the reply.  We used to do it that way also, with a statement saying "seen and examined by Dr __"....but now CMS is saying this , “A summary statement such as ‘seen and examined' or ‘discussed and agree' *is not sufficient to describe *the physician's involvement.” 

That's the pickle...any suggestions?


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## jettagirlfl (Oct 15, 2010)

well usually our doctors here have a attending note attached to their statement. Maybe you can let your Dr's know this is necessary... hope that helps


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## mitchellde (Oct 15, 2010)

The AMA stated that the physician must state that they personally examined the patient and restate any patient concerns and a short but relevant exam.  Then they can state that they have read the assesment provided by the NP and agree with everything stated.  This then can be billed under the Physician.


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## Texmexsop1 (Oct 16, 2010)

Thank you both so much. I'll work on them !!


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