Covering arrangement


Pittsburgh, PA
Best answers
Our surgeons were on staff providing limited surgical services for a distant hospital 90 minutes away because they needed specialty coverage. The hospital recently hired a private physician/surgeon to now fully staff the facility. This new doctor is not part of our practice. He will be seeing patients we did surgery on while we were providing services to this facility. Is he able to bill for the visits during the postoperative period of our surgeons? I realize he is not part of our practice & wouldn't normally be held to our post op days, but we had an arrangement with the hospital & now they have put him in place.

Our surgical patients are complaining that they shouldn't have to pay him a copay/visit for post operative care. Thoughts?

Thank you,
This other physician which is providing post-op care but is not part of your practice should be billing the same surgery codes used by your physicians, but with a modifier 55--Postoperative management Only.