Wiki Billing for assistant surgeon

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kjstearns

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Our PA's often assist surgeons from other groups. Do we need to wait for the primary surgeon to submit their claim before we can submit ours for the PA? We have been waiting months and my concern is that they will not submit a claim at all or if they do it will be denied due to timely filing. Is our PA just out this $$?

Thanks,
Kirsten, CPC
 
PA billing

We have a group that assists us on some of cases. I supply them w/a HCFA showing all the patient info, ins and codes. If you have problems getting the info from the surgeons, you might want to deal directly with their Billing Manager so that there wont be a delay. As Mary said, if the PA's have contract deadlines, you will have issues if the surgeons dont help you out. You may have to resort to getting the op report and coding them yourself.
 
Thanks for your responses. I have no problem coding them out myself. I've been told though that insurance won't pay for the PA until they receive the surgeon's claim, but I'm not sure that sounds right..... your thoughts?
 
phoover1955 said:
[...] You may have to resort to getting the op report and coding them yourself.
Click to expand...

I code from the op note, but we have an internal policy that no billing can be done until the op note is signed. We do lose an occasional billing opportunity, but I find that speaking to the surgeon's billing manager can get the job done in most cases. I do understand your frustration, however - I hate messing up my workspace with unbilled paperwork!
 
kjstearns said:
Thanks for your responses. I have no problem coding them out myself. I've been told though that insurance won't pay for the PA until they receive the surgeon's claim, but I'm not sure that sounds right..... your thoughts?
Click to expand...

Regarding the timing issue, since the PA's work for "us", and the surgeons have their own practices separate from ours, I bill as soon as I see the op note signed - I don't need to drive myself crazy by trying to figure out when "their" billing staff is going to get around to billing for the surgery.
 
Thanks Brad! I didn't think that was right that we were holding our PA's claims and waiting for the surgeons to submit theirs. Looks like it's time to clean off the desk :)
 
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