Wiki Inpatient rounds with a midlevel

[efuhrmann]

My clinic is hiring a midlevel provider to be stationed at the hospital for Cardiology patients and rounds. I am looking for any information that would be useful. Some scenarios would be: if the midlevel only sees the patient; if the midlevel only sees the patient twice in one day; if the physician and midlevel see the patient in the same day; what criteria needs to be met to bill under the physician; if the midlevel bills under him/herself does he need a Medicare number; what about commercial insurance?? I work at a multispecialty clinic and within the clinic is a very busy Cardiology department with 2 physicians and this is where the midlevel would be employed. As I said, this person would be at the hospital(across the street from my clinic) with the primary responsibility of following up on those patients admitted or being followed by Cardiology. HELP please.

 

[mitchellde]

the incident to criteria does not apply to services provided in the facility setting. To bill under the physician for a Midlevel to see a patient in the facility, the physician must see the same patient on the same day and write his/her own progress note indicate the NPs note was reviewed. Just signing off on the NPs note is not sufficient to bill under the physician NPI. This is a shared encounter and cannot be done for New patients or consults. All facility visits by the NP must be billed under the NP NPI unless the shared services requirements are met. If the NP sees the patient 2 times on the same day you can charge for only one visit which can be the combination of the 2. Your NP will need to be credentialed with all your payers.

 

[efuhrmann]

Thanks Debra. Awesome info.