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Fellow doctor's

  1. #1
    Default Fellow doctor's
    Medical Coding Books
    When billing for a fellow with a resident would you use the same guidelines as a physician and resident ?

  2. #2
    Location
    Milwaukee WI
    Posts
    4,466
    Default Where's the faculty?
    For Medicare and Medicaid: Fellows are NOT billable; they are considered the same as residents. Documentation must shows the physical presence and involvement of the teaching physician in order to bill under the teaching physician's name.

    If it is a commercial claim ... SOME commercial carriers do not require the physical presence of the teaching physician and allow the claim to be billed under the teaching physician name as long as the TP was available in the general area or even by phone or any other reasonable means of communication.

    Check your carrier contracts.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Default
    The fellow's bill under their own name and number.

  4. Default
    If you're billing under the fellow's name and number, I'm assuming your facility is not receiving GME payments for them? In other words, these fellows have come to you because they want/need the experience and are hired on as an associate so to speak. They are not part of the GME program so Medicare does not send your facility any money for their services. This needs to be true in order for you to bill for your fellows directly. Otherwise, its as Tessa said, fellows are considered the same as residents.

    If they are associates, I'm not sure about the billing guidelines with residents - I happen to be looking into this myself. I'm assuming an associate fellow cannot link to a resident note because they are not considered to be the teaching physician (your attendings would be). If anyone knows the answer to that, I would like to know. My gut says no but I'm not 100% sure.

    Lisi, CPC

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