We have an MD and an NP that round together at the hospital, they see the patient, go over everything and establish a plan together. The NP then acts as "a scribe" and dictates the actual consult and puts the orders into the system. She has been starting her notes by making the remark "this note will be co-signed by ..." but makes no mention of the fact that the physician was present during the exam and established the plan. Also, in terms of billing I am wondering whether or not billing the NP (rendering) and MD (supervising) is truely capturing the situation. I feel that may be creating an "incident to" scenerio when I do not think that is what the situation is. I would greatly appreciate any feedback you have. Thank You.