Wiki Inpatient Consultations by fellows

[BLTHW@outlook.com]

In our office, we have fellows who work with our attending physicians but are not classified as participating physicians since they are only with us for a year or two at a time. If a fellow sees a patient and completes an inpatient consultation, then confers with the attending and the attending signs off on the documentation, can that consultation be legally billed by the attending physician?

 

[Cyndi113]

That is how we bill for our fellows. However, if they are with us for a year, we will actually contract them with insurance companies. BC will not contract a fellow but there are others who will. You also need to make sure that the subsequent day chart notes are all co-signed.

 

[FTessaBartels]

It Depends

It depends on whether you are in a teaching hospital and your physician is considered a teaching physician AND on whether the patient is covered by a government payer or commercial.

Government payers do not reimburse for fellows who are performing within their training. The Teaching Physician must personallyattest to his/her personal involvement - The TP must have seen and examined the patient, reviewed the history, and concur with the assessment and treatment plan outlined in the fellow's note.

For Commercial payers, a statement by the fellow that the patient was discussed with Dr Teaching Physician who concurred with plan, with TP countersignature, is usually sufficient.

If the fellow is "moonlighting" in your office, s/he should be independently credentialed and bill under his/her own name/NPI.

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[BLTHW@outlook.com]

Thank you....responses are very helpful.
Barb