Consulting in a hospital that your not employed by

[lburgos31]

So I may have asked a similar question before but i wanted some clarification.

If our orthopedic doc signs off on a resident's documentation for consult, would it be billable under our doc if our doc is not employed by the hospital?

If so, wouldnt our doc have to be designated as an instructor in the approved training program of that Resident?

If not, please explain why in detail with any supporting references.

Thanks

 

[csperoni]

I am not aware of any requirement that your physician must be employed by the hospital or designated as an instructor in order to bill as a teaching physician.
Below are links to CMS issued guidelines:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Teaching-Physicians-Fact-Sheet-ICN006437.pdf

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c12.pdf

On the 2nd link, page 151 defines teaching physician as "A physician (other than another resident) who involves residents in the care of his or her patients."
I see no reason why your doc could not bill for the service, assuming the documentation includes that he was present.

 

[thomas7331]

The one concern I would have in this situation is if your physician is in fact not the instructor, then he or she might be double billing the work of the actual instructors at the hospital. You may wish to coordinate this with the hospital to ensure that this isn't occurring.

 

[lburgos31]

The one concern I would have in this situation is if your physician is in fact not the instructor, then he or she might be double billing the work of the actual instructors at the hospital. You may wish to coordinate this with the hospital to ensure that this isn't occurring.

This is exactly what I need answered. Thank You