New Patients

Can a FNP see a patient in one of our ancillary clinics then send patient to our specialist office and they be seen by a FNP in the specialist office be billed as a new patient. Also what if the specialist sees them for the first time. We are all in the same group.

re: New Patients

If following Medicare rules, then if one FNP sees the patient, another FNP would bill established, because the FNP doesn't have any other specialty designation. Most private payers will enroll the FNP with a specialty. I have been hearing that there are Medicare Contractors who are not processing according to their own stated rules.

It is a problem: there is no clear, consistent processing.

re: New Patients

Then could the specialist bill as new if he has never seen the patient.

re: New Patients

Per CPT® guidelines, 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.