Wiki New pt vs Est Pt

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nneecole44

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I work in a 4 doctor 2 physician assistant family practice clinic. We recently hired a new PA and she brought 300 established patients with her. Now, I have done a ton of research and I hope I have this right. The new PA's established patients at her old clinic would be established patients for her at our office. But what if one of our physicians or PA's see her est patients but have never been seen in this clinic before and no previous medical records are available? Is this still billed established? I think so. Please help.
 
Ok and a few more questions on the above info. When the new PA's Medicare patients come in to get established with a physician in our office is this still considered an established patient visit? From my understanding all Medicare patients must be established with a doctor for new problems or being a new patient but can see a PA for follow up. Senerio 1:A Medicare patient is scheduled with a PA and a new problem comes up. The PA goes and gets the doctor to assess the patient. What kind of documentation is required for this. Can the PA just document the visit and the doctor's presence and what was planned and record the time face to face time with the doctor in her note? Or does the doctor have to dictate this. And I am very confused if I bill a new patient for the new PA's established patients that are seeing our doctors for the first time. Ahh. I hope I didn't just confuse the heck out of you.
 
All 300 patients will be new to the practice. Medicare rule: a new patient must be seen by a physician. They could be billed as established if this new PA bills under her own NPI number(my guess). Again, why would she, if 4 doctors are present, she can get 100%, and her pay is only 85% of full amount?
 
Ok. So you are saying if the PA sees her own est pts and bills under her own Medicare number they are established. But if her est pts come in to get established with one of our physicians then I bill new patient? I looked this up on the Medicare web site and from what I gather is that if the patient is established with ANY provider in the office (new to the facility or not) then we can't bill a new pt. Uhg.
 
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