For government payers -- In a teaching facility, the teaching physician must attest that s/he was actually present and participated in the exam, assessment and medical decision making. Just counter-signing a resident's note is NOT sufficient documentation.
For commercial payers -- MOST commercial payers define "supervision" as by any means of communication. If the resident says s/he discussed the case with Dr Teaching Physician that is usually considered sufficient. A counter-signature is also frequently accepted. This will depend on how your payer defines supervision, and may vary greatly from payer to payer.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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