Wiki New or established patient??

[torih@nwurology.com]

Hi,

We have a tricky situation that I'm trying to get clarification on. We had a doctor join our group 3/1/16 from another clinic. Due to contract issues he can not see any of his existing patient's for two years. However, those patients can see other providers in our practice. Would these patients be considered new or established to the other providers? Same specialty.

Thanks
Tori

 

[ivycoder2014]

New vs Established

Hello, its my understanding reading the CPT difference from Established to New Patient for your scenario is if its the same or different group practice. If your new provider came from a different group practice he or she should be able to charge NP level. Thanks!

 

[mhstrauss]

Hi,

We have a tricky situation that I'm trying to get clarification on. We had a doctor join our group 3/1/16 from another clinic. Due to contract issues he can not see any of his existing patient's for two years. However, those patients can see other providers in our practice. Would these patients be considered new or established to the other providers? Same specialty.

Thanks
Tori

This situation was brought up in a Q&A session at a MAC conference (we have Novitas) a few months ago. The rep stated that Dr. A's patients would be considered established when seeing any of the other providers in the group he just joined.

 

[beulastella]

NEW VS Established

The physician has joined new to the current group hospital (B) from hospital (a). In case of the patient is seen in this current group hospital (B) before and this physician is new there then it can be considered established, But here the though the physician saw the patient already in hospital (A), but Now he is not under the same hospital, and even if the patient is seen by the same group of physicians with whom he joined now also cannot consider the visit as established and its new, the next visit will be established.