NishaJ
Guru
Hi ....
A patient has seen by a Pulmonologist Dr. A and he admitted the patient in Hospital, and we have filled the claim with Tax ID XXXXXXXXX1, and once he discharged from this hospital, the patient has seen by another pulmonologist Dr. B in his clinic, but still both claims are filled under same Tax ID. Here is this patient NEW or ESTABLISHED for Dr. B. How we can bill to Dr.B..
Im confued with this ...
http://www.aafp.org/fpm/2003/0900/p33.html
Defining “group practice”
Although groups with multiple practice sites may operate independently, with each caring for its own patient population and maintaining its own medical records, they are considered a single group if they have the same tax identification number.
In a single-specialty practice, the patient’s encounter should be reported with a code in a new patient category only if no physician or other provider who reports services using CPT codes in that group has seen the patient within the last three years. For example, let’s say your partner saw a patient who is new to your practice in the emergency department (ED) over the weekend. The following week you see the patient in the office. Since someone else in your practice has seen the patient within the last three years, you have to use an established patient code. This is the case even though the patient had not been seen in the office and there was not an established medical record there.
Incase, if the speciality is same , but they have billed under different TAX ID means, how we can bill this patient for DR.B....
Anyone make me clear on this ..
Thanks in advance....
A patient has seen by a Pulmonologist Dr. A and he admitted the patient in Hospital, and we have filled the claim with Tax ID XXXXXXXXX1, and once he discharged from this hospital, the patient has seen by another pulmonologist Dr. B in his clinic, but still both claims are filled under same Tax ID. Here is this patient NEW or ESTABLISHED for Dr. B. How we can bill to Dr.B..
Im confued with this ...
http://www.aafp.org/fpm/2003/0900/p33.html
Defining “group practice”
Although groups with multiple practice sites may operate independently, with each caring for its own patient population and maintaining its own medical records, they are considered a single group if they have the same tax identification number.
In a single-specialty practice, the patient’s encounter should be reported with a code in a new patient category only if no physician or other provider who reports services using CPT codes in that group has seen the patient within the last three years. For example, let’s say your partner saw a patient who is new to your practice in the emergency department (ED) over the weekend. The following week you see the patient in the office. Since someone else in your practice has seen the patient within the last three years, you have to use an established patient code. This is the case even though the patient had not been seen in the office and there was not an established medical record there.
Incase, if the speciality is same , but they have billed under different TAX ID means, how we can bill this patient for DR.B....
Anyone make me clear on this ..
Thanks in advance....
