Wiki New Patient after an Employee paid physical or established?

[elb38366]

Hello,
In 2016 we had a patient sent by Nursing Home for an employment physical. Paid by the NH. This year the same patient returns this time to establish care and her insurance will be billed. Is she considered established since she was seen by same NP? Or new, because the previous only visit was paid for by employer and not billed to health insurance?

 

[thomas7331]

The code definition for a new patient is based on whether or not the patient had a face-to-face encounter with the provider, not based on whether or not the payer was billed, so this should be an established patient.

 

[elb38366]

Thank you.

The code definition for a new patient is based on whether or not the patient had a face-to-face encounter with the provider, not based on whether or not the payer was billed, so this should be an established patient.

That was my thought but I wanted proof for the Provider.