Wiki New vs Est patients

[lajames]

I work for a group of pediatricians. We recently acquired another four Drs from another practice . I realize that the patients who follow these docs would be established. What if one of our existing Drs sees a patient that follows the Drs we acquired?
Would they be new or established?
Thank you for any advise!

 

[jkyles]

Hi there, the general rule is that if the doctors are all of the same specialty and subspecialty the patient is established.

However, even if there are different sub-specialties you need to make sure the payer recognizes subspecialty.

 

[lajames]

Thank you!

 

[podcoder70]

If they are all billing under the same tax id then the patient is not considered "new" until 3 full years have passed without the patient being seen if it is within the same specialty.