Teaching physicians & hospital employed nurse practitioners

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Good morning everyone! I have a question that I hope someone may be able to help me with. We have teaching physicians that cover the medical ICU and bill for those visits or procedures done while there. There is a nurse practitioner that is employed by the hospital that sees these patients as well and does a full documentation into the patients chart. However, the hospital does not bill for any visits or procedures done by the NP. The teaching physician sees the patient and then reviews the notes written previously that day by the NP and writes a couple lines of notes themselves (just as they do with the residents) and bill for the visit. Can a teaching physician use the notes of the hospital employed NP as part of their documentation or should they be doing a full documentation themselves? I contacted our compliance department and presented this question to them and their answer was the doctors cannot bill for anything done by a hospital employed NP, even if they supervised it, wrote a note behind it, etc. My physicians say this is incorrect information and all of the physician in the different ICU's document this same way in order to bill. I certainly don't want to be doing anything illegal but have been unable to find a definite answer to this situation. Any help will be greatly appreciated!
 

mcandia

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No, your physicians cannot bill for services performed by an ARNP employed by the hospital.
The Teaching Physician should not be utilizing the ARNP's note for billing purposes.

The ARNP would have to be credentialed, have a contract and be employed by your facility / practice in order to bill for the services.

I would have someone in compliance do a spot check and let them educate the physicians.

If they are using any portion of the note to count towards billing this is incorrect.



Maria CPC, CPC-H, CPCO, CPMA, CEMC
 
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Thank for your help Maria. I knew it was not acceptable practice but just needed proof. Another poster gave me 2 different websites showing medicare guidelines on this. I will try presenting this information to them and hopefully, they will change the way things are being done. If they still are in disagreeance, I will definitely contact the compliance department again.
 
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Except ...

Please note that the physician MAY use ROS and PFSH documented by anybody (including a hospital-employed NP) ... as long as the physician documentation specifically states the physician reviewed the documentation and location of said documentation.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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