MAWK
Networker
this question might of been asked before but my question is if new provider (chiropractor) joins a practice has own NPI but his claims will be billed with same Tax ID as rest of providers in practice would his patients be new?
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Wiki new patient?
- Thread starter MAWK
- Start date
CodingKing
True Blue
Same provider in last 3 years = established. This applies regardless of what TIN the provider uses. Assume patient sees Dr A in California and the 2 years later Dr moves to New York and same patient is seen. Its still established. Group practice (defined by TIN) only comes into play when its a different physician.
MAWK
Networker
Patient is new to Chiropractor but established with other providers in same facility would that be a new patient visit for the chiropractor?
Agilbert3
Networker
In this case, the patient would be new to the chiroprator IF the other physicians have different specialties and/or subspecialties.
This has been a helpful guidelines for our office.
A new patient is one who has not received any professional services from:
· The physician/chiropractor or another physician/chiropractor
· Of the exact same specialty and subspecialty who belongs to the same group practice,
· Within the past three (3) years.
An established patient is one who has received professional services from:
· Thephysician/chiropractor or another physician/chiropractor
· Of the exact same specialty or subspecialty who belongs to the same group practice,
· Within the past three (3) years.
Examples:
· Patient was seen by a Pediatrician and returns to see either the same or different Pediatrician within the past 3 years at the same practice; the patient would be an established patient.
· The same patient comes back to see an Orthopedic provider within 3 years from seeing thePediatrician. The patient is considered a new patient since the Orthopedic provider is a different specialty from the Pediatrician.
· A patient sees a Dr. Green and then sees Dr. Brown at the same office; different provider but same specialty; within the past 3 years, the patient would be an established patient.
· A patient sees an Orthopedist for the first time on Tuesday and the next day goes toa Family Practice Physician. The patient would be a new patientvisit for both clinics since they are seen by different specialties.
A new patient is one who has not received any professional services from:
· The physician/chiropractor or another physician/chiropractor
· Of the exact same specialty and subspecialty who belongs to the same group practice,
· Within the past three (3) years.
An established patient is one who has received professional services from:
· Thephysician/chiropractor or another physician/chiropractor
· Of the exact same specialty or subspecialty who belongs to the same group practice,
· Within the past three (3) years.
Examples:
· Patient was seen by a Pediatrician and returns to see either the same or different Pediatrician within the past 3 years at the same practice; the patient would be an established patient.
· The same patient comes back to see an Orthopedic provider within 3 years from seeing thePediatrician. The patient is considered a new patient since the Orthopedic provider is a different specialty from the Pediatrician.
· A patient sees a Dr. Green and then sees Dr. Brown at the same office; different provider but same specialty; within the past 3 years, the patient would be an established patient.
· A patient sees an Orthopedist for the first time on Tuesday and the next day goes toa Family Practice Physician. The patient would be a new patientvisit for both clinics since they are seen by different specialties.
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