Wiki New Patient vs Established Pt Question


Belfast, ME
Best answers
We have a new provider to our practice who is bringing established patients with her . The question is even though we have not seen the patient before the patients have seen this provider within the last three years would you code this as a new or established patient for their first visit within our organization ?
We had the same situation here a few years ago. They had to be billed as established patients. A few times we did not know they had seen the doctor in his previous practice, billed them as new and the claims denied.
If that specific provider sees the patient first, it's established. But, in an unlikely scenario, if another provider in the office sees the patient first, then it's a new patient.