Wiki Residents

[Gemini18]

I work for a hospitalist group and this came up and I don't quite know the answer:

Is there a statement used for when a resident writes up an H&P and signs off on it -- how can it be billed under the supervising physician?

 

[LLovett]

http://www.cms.hhs.gov/MLNProducts/downloads/gdelinesteachgresfctsht.pdf

The teaching physician has to be involved, see the patient as well, and document in order to bill.

My providers don't utilize residents often or appropriately so we don't bill for those services. Hopefully the above link will be helpful.

Laura, CPC, CEMC

 

[FTessaBartels]

Teaching hospital

The teaching physician must include an attestation of his/her participation in the case.

A sample statement is usually something along lines of:
Patient seen & examined with resident. I participated in the history, exam and medical decision making with resident, and agree with his documentation. The note is then signed and dated by the attending.

Our dictation system does NOT allow residents to sign notes (although they will be listed as the dictating physician). Attendings are responsible to include the attestation statement before signing the note.

NOTE: if the patient has commercial insurance and the resident has indicated that he discussed the case with the attending we will bill for the attending's service. Most comercial insurance carriers do NOT require actual face-to-face attendance by the teaching physician. Our biggest problem in these cases is that residents frequently use the notation "Discussed with staff." Well, there are hundreds of doctors on staff ... which one? Of course this doesn't affect the residents at all, so it's difficult to convince them of the need for this (until they finish and find themselves as supervising physicians with residents under them...)

Hope that helps.

F Tessa Bartels, CPC, CEMC