If I was the physician, I would make a follow up appointment for 3 days following the surgery for the parents to bring the young child back in. That way, he could make sure the post op care is being done.
I almost wonder if CPS could be contacted too. All anyone has to do is suspect some form of abuse/neglect and they will go investigate. So, if the follow up appointment was made and the parents cancelled it -(With NO appointment rescheduled) - contact child services and tell them flat out - family member reported a possibilty of non-compliance after a surgery on the toddler and they failed to come in for post op care.
I realize that this could (and probably will) open up a whole can of worms, but I really think that in a case like this the provider should really be on the lookout for that little girl. I can only imagine why the relative changed her story, maybe she was afraid the child would be placed into foster care - or a host of other reasons. But the fact is - she was concerned enough to mention it in the first place, so that should be a red flag right there. Who knows, maybe she recinded because she didn't want to be "stuck" with the toddler herself.
As far as what the billing could be, can he bill discharge services? Seeing how she was kept overnight, I wonder if the discharge day codes could be billed since he spent time reviewing the post op care with the patient's parents.
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