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New patient or not ???

  1. #1
    Location
    Salt Lake North
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    639
    Wink New patient or not ???
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    Patient leaves a practice where they have been seen by a specialist and decides to come to our office instead. Our doc is of the same specialty as their doc at the previous clinic. So with us, are they a new or established patient. The patient has never been to our clinic, its just that our doc is of the same specialty as their previous doc. I think they should be a new patient. What do you think?

  2. Default
    Quote Originally Posted by qcoder View Post
    Patient leaves a practice where they have been seen by a specialist and decides to come to our office instead. Our doc is of the same specialty as their doc at the previous clinic. So with us, are they a new or established patient. The patient has never been to our clinic, its just that our doc is of the same specialty as their previous doc. I think they should be a new patient. What do you think?
    They are New patient to your practice if they've not been seen within the last 3 years under your Tax ID#. New or Established has nothing to do with specialty...just whether billed under same tax id.

    Jenna

  3. #3
    Location
    Salt Lake North
    Posts
    639
    Default
    I agree with you but I got a doc that is not agreeing with me. Just wanted a second opinion. Thanks.

  4. #4
    Wink
    You can use the official CPT E&M Guidelines and show them to your doc - "A new patient is one who has not received any professional services from the physician or another physician of the same specialty who belongs to THE SAME GROUP PRACTICE, within the past three years." Hopefully that will persuade him or her.
    Laura Blandin, CPC, CHCA, CPMA

  5. #5
    Location
    Milwaukee WI
    Posts
    4,466
    Default Same group practice
    You may be at a different location (different clinic) from the previous doctor, but if you are in the same group practice, then it's an established patient.

    As an example "Metropolitan Cardiac Specialists" may have clinics/offices in several places around town. If a patient went to see Dr A at the ABC clinic; and then went to see Dr X at the XYZ clinic ... BUT BOTH were in the same group practice and same specialty, then the patient would be established for Dr X.

    Hope that made sense.

    However, if your physician has NO connection to the previous doctor, then the patient is NEW to your doctor for that first visit.

    F Tessa Bartels, CPC, CEMC

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