question on new pt vs est pt

tarism

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I work at a Family Practice and we recently had a ARNP join us from another family practice location. She is bringing her pt here to our practice. bcbs is stating that these patients would be established and not new. I thought they would be new because its a different practice. same specialty though. Does anyone know which is correct? please help asap!! Thanks in advance!!! taris
 

CodingKing

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It will depend on who they are seeing. You can be established to the provider or the practice.

If they happen to see someone else on the first visit to the clinic that would be a new patient visit since they are both new to the provider and the Practice (TIN)

If they see the APRN on the first visit to the new practice its established patient.
 
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