Marie, you have my sympathy.
Because your docs have priveleges at the hospital, you should have access to the medical records for billing purposes. Contact the director of Medical Information to see how you might be able to work together to get those records. Here at WDH, we have provided our non-employeed providers who have priveleges with access to our electronic medical record so that they can sign off on their charts, but also so that their billing staff can veiw the physician documentation for billing purposes,. They still have the ability to contact the medical records department for hard copies if they are needed. We have this arrangement with several facilities for whom some of our physicians consult. We request the notes and they send them over. You may not be on an EMR, but if the hospital has one, you may be able to have 'view only' access for your patients.
It's cumbersome, but I'd encourage you to get the documentation in your hand before you bill out the charges, particularly if you're being asked to bill an E&M for a visit within the surgical global days....you need to see the dates and documentation for compliance purposes. Without seeing the actual medical record, in essence, the visit isn't supportable. Sure, the docs say that the documentation exists, but I would remind them that in an audit, you would be required to provide the documentation, and that it better match what you billed. You're also correct in that without the documentation to review, you may be missing out on significant revenue.
Keep us posted. Pam
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