I agree with @thomas7331
that there does not seem to be any cause for alarm here. Impossible time to me means literally billing for more than 24 hours in a day. There's more frequently what I call "suspicious time". It doesn't mean it's not possible, just rather that it's unlikely. Like if a provider is scheduled for 6 hours of patients, every 15 minutes with an hour for lunch (20 appts for the day; 4 new and 16 established). They then document for every new patient as 45 minutes and every established patient as 30 minutes. If you do the math (4x45 + 16x30) you wind up with 11 hours, which is actually very possible. The real suspicious part here is that every new patient is 45 minutes and every established 30 minutes. I would actually find it less suspicious if those 4 new patients were documented as 46 minutes, 52 minutes, 47 minutes and 51 minutes. While the insurance company would not have access to all 20 records, your internal people (like compliance) certainly do. Time documentation that is suspicious then casts a dark shadow on everything else.
I personally do not advocate for putting time on all records. It creates an unnecessary burden for most clinicians to monitor all time for all patients as it is not contiguous. They would have to keep track of:
12 minutes in the morning reviewing records, labs & CT results
24 minutes with the patient for history, exam and medical discussion (excluding any time spent on a separately billed test)
10 minutes charting - entering orders, sending prescription, note documentation
If I had a job where part of my job was to keep track of the exact number of minutes I spent every day on every single work activity I did, I would be looking for a new job.
I encourage my physicians to document time ONLY for noticeably time consuming patients. And include in the documentation some explanation.
There are certain types of specialties where documentation for all or most patients would not be burdensome and the majority of patients are time consuming (like palliative care). But for most clinicians, most patients, they could reach a new patient 99204 in far less than 45 minutes of clinician time.