Can an Emergency Visit be billed if the patient is seen an RN....

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Lakewood, CA
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But consults with a physician on the phone or via secure face to face chat?

We are in the process of opening a free standing specialty OB/GYN Emergency room. The physicians are creating protocols for each situation. What I need to know, if the RN treats a patient for say a urinary tract infection or vaginal irritation, does a doctor need to be called into the ER and see the patient to bill an ER E/M code, or can the RN follow protocol and consult with a physician via a HIPAA compliant video chat, or phone call, and sign off on the plan and treatment verbally?

Any insight is greatly appreciated.
 

mitchellde

True Blue
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Columbia, MO
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Not if it is not a hospital ER. The hospital may bill a facility visit for ER encounters of any kind, however the provider may not. If this is a free standing ER, then no an RN is not licensed to diagnose and treat a patient. If the provider does not see the patient face to face then the provider cannot bill for the encounter. You need to look into the state licensing requirements for a free standing ER. It is not as easy to establish as it may seem depending on the state. I worked for a company that tried to do this in a state and ultimately they had to have a physician staffed there 24hours a day to be able to call it an ER. Another state I worked in had a requirement that all ER designations be physically attached to a facility with 24 hour physician staffing. Your state may have some specific requirements as well.
 
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