Wiki Covering Doc Delivers!!

[kinzua23]

Just wanted some input on the subject of covering physcians. I am new to OB/GYN. I bill for two doctors who are at the same location but not a group and bill completley individually. Doctor A was out of town and signed out to covering Doctor B. Doctor B ended up delivering 2 of Doc A's patients. I thought Doc B would bill for delivery only and Doc A just antepartum, HOWEVER, in the past it was billed as , Doc A still bills global code for delivery and pays Doc B a predetermined " per diem covering fee". Is this allowed and legal? ( Doc B's name is on summary of L&D birth report) Does this fall under the rules of covering doctors???????? HELP PLEASE!!!!!!!!

 

[pmayenschein]

Covering Docs Delivery

You can bill using Dr A if you use modifier Q6 Service furnished by a locum tenens physicians, which tells the Ins Co that a covering Phy provided this service for Dr. A.

 

[jdsmith]

The office I work at bills the same as you just described. I haven't ever used Q6 but I'm going to look into it. I wonder if it reduces the allowable??

 

[LanaW]

Our office bills delivery to commercial payors as the MD who has seen the patient for the antepartum care. Medicaid is billed delivery only to the delivering MD and postpartum to the MD who gave antepartum care. I have also never heard of the Q6 modifier for this type service.

 

[ladyk113]

delivery

I would hate to get us into any trouble but I work for a practice that occasionally shares call with another group. We have each delivered the others' patients. We have an agreement to bill our own. If they deliver our patient we still bill the entire global- or whatever is appropriate. My two current physicians also take turns on call so they deliver whoever comes in - it doesn't matter who they are. We divide the billing not the reimbursement- I don't like it and think that the accountant should sort it out each month but that is how they have always done it. My previous group covered for each other (4 docs vs the current 2) and I billed out who delivered- They split the reimbursements in quarters with each taking equal shares (they had the obs rotate) so it seemed more legit and easier to comply with. I guess it depends on who you work for.