bkerste
Contributor
Hi all,
I've gotten myself confused and need some assistance. UHC Med Adv has been returning a denial 'new patient qualifications have not been met' for some of our claims with a new patient OV. I have noticed several of these claims have involved one of our new Dr's who have patients following them to our practice. I am aware that if "Dr Smith" sees a patient from his old practice for the first time at our practice, the patient is still considered an existing patient (despite difference in TIN). Where I'm confused is how this applies to patient's who's first visit, at our practice, is with one of our nurse practitioners or Dr's who were never affiliated with "Dr Smith's" old practice. Would these be considered new patient or would this fall under the 'covering physician' guidelines and be billed an existing patient? Any assistance is appreciated, TIA!
I've gotten myself confused and need some assistance. UHC Med Adv has been returning a denial 'new patient qualifications have not been met' for some of our claims with a new patient OV. I have noticed several of these claims have involved one of our new Dr's who have patients following them to our practice. I am aware that if "Dr Smith" sees a patient from his old practice for the first time at our practice, the patient is still considered an existing patient (despite difference in TIN). Where I'm confused is how this applies to patient's who's first visit, at our practice, is with one of our nurse practitioners or Dr's who were never affiliated with "Dr Smith's" old practice. Would these be considered new patient or would this fall under the 'covering physician' guidelines and be billed an existing patient? Any assistance is appreciated, TIA!