Medical Billing Forum

Coding => Coding => Topic started by: bjackson81 on May 06, 2010, 01:22:15 PM

Title: new patient vs. established patient
Post by: bjackson81 on May 06, 2010, 01:22:15 PM
When a physician moves from one practice to another and a patient moves with him do you bill for an new patient or an established patient?
Title: Re: new patient vs. established patient
Post by: oneround on May 06, 2010, 02:14:16 PM
Same Dr.  Pt would be eslablished
Title: Re: new patient vs. established patient
Post by: mikemeno on September 15, 2010, 09:12:12 AM
When a physician moves from one practice to another and a patient moves with him do you bill for an new patient or an established patient?
if we offer flu shots, and the patient only gets the shot, and no vitals or demographic info is taken, and no insurance is bill, does this make the patient new or established for their next visit?
Title: Re: new patient vs. established patient
Post by: PMRNC on September 15, 2010, 12:31:03 PM
hmm  I have done pediatrics and family physician and none of our physicians give even a single flu shot unless the patient has at least a history/physical..  I would say you could bill a new patient but I'm not a coder so I'll let someone else confirm that one.
Title: Re: new patient vs. established patient
Post by: DMK on September 15, 2010, 01:35:38 PM
That's what I was thinking too!  Unless it's a "flu shot clinic" like the pharmacies put on, the doctor still has the same liability and malpractice issues.  They should absolutely be an established patient with an exam and history!
Title: Re: new patient vs. established patient
Post by: oneround on September 15, 2010, 01:42:46 PM
Eventhough there is no face to face encounter on the intial I would consider it new and any suqsequent vists after would be establised.
Title: Re: new patient vs. established patient
Post by: PMRNC on September 15, 2010, 02:36:59 PM
I would still have to question the potential for trouble if it's a physician practice and a patient walks in off street or comes in for first time and gets flu shot.. That just does not sound right to me.
Title: Re: new patient vs. established patient
Post by: Michele on September 16, 2010, 12:50:26 PM
We have a physician that did H1N1 flu shots for walkins last year.  The state/gov provided the vaccine and he could not charge for the injection, only the administration.  He had many patients that he did not have any history on.  There was very specific paperwork/protocol he had to follow and patient had to sign, however, he did not do and could not bill for an office visit.  Therefore, no history, etc, information gathering, so if the patient came back in at a later date for an appt, it was a new patient.

Michele
Title: Re: new patient vs. established patient
Post by: PMRNC on September 17, 2010, 05:58:38 AM
But didn't he have to setup as a flu clinic? Aren't there guidelines on that ?
Title: Re: new patient vs. established patient
Post by: Michele on September 17, 2010, 07:14:10 AM
I'm not sure if he did, I wouldn't have been involved in that part.  I know he's very up and up and wouldn't do anything not right by the book.  He is a strong believer in the H1N1 flu shot.  He's done a book and a video (DVD) on it and the flu epidemic in the 1920's.  He wanted to make sure people had access to free immunizations.  I personally had mine from him and I had to do all the paperwork.  He said "I gotta make sure all these papers are done right every time I give a shot" so I know he had done what he needed to to be able to give the vaccines.  I just don't know the details.  Now I will have to ask him, I see him on the 27th.

Michele