Wiki signature on note ?

[RebeccaB]

Our group hired an NP that has been training with the PA, the NP saw the patient and did the note but the PA signed the note..is this allowed & if so how does this get billed ??
This is a new area in for us so any help with NP guidelines would be much appreciated

Thanks,
Rebecca

 

[thomas7331]

Notes need to be signed by the author - the provider who actually saw the patient, rendered the services and documented them - and billed under that same provider's credentials (unless billing under 'incident to' or locums arrangements, which would not be the case here since both providers are mid-levels). It's not really meaningful for one provider to sign another provider's notes, other than as a training tool or way to record for informational purposes that the supervising provider reviewed what was in the note - this would not affect how you would bill for the service.

 

[Chelle-Lynn]

So if I understand correctly, you have an NP on staff that is training with a PA. The NP saw a patient and documented the medical records, but the PA is the provider who signed the medical records?

Was there a reason that the PA would do this...such as the NP is not credentialed yet and they were trying to make the account "payable"? It is not appropriate for a PA to "sign off" on an NP documentation. Under billing guidelines this is only allowable in regards to an NP and MD.

Was the PA present during the examination and as part of the training had the NP document the visit but the PA did the actual service?

 

[Sue2424]

Incident to/ locums

Notes need to be signed by the author - the provider who actually saw the patient, rendered the services and documented them - and billed under that same provider's credentials (unless billing under 'incident to' or locums arrangements, which would not be the case here since both providers are mid-levels). It's not really meaningful for one provider to sign another provider's notes, other than as a training tool or way to record for informational purposes that the supervising provider reviewed what was in the note - this would not affect how you would bill for the service.

Can you tell me if a nurse practioner can be billed incident to a locums??

 

[Chelle-Lynn]

There is no specific restriction for a Locum Provider and a NPP billing incident to. As long as the requirements are met for incident to, it can be billed.