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Billing as a hospital employee when Attending Surgeons are not


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As the title states- recently took a job on trauma/ICU as an employee of the hospital. The surgeons I work with are sub-contracted, not considered "hospital employees."

 

So I learn that they (our service) are not billing for me or my colleague (NP).

 

There is no answer from directors, as I suspect they dont want to dig enough to find a solution, or dont know how.

 

Anyone have experience with anything like this?

 

Is this typical?

 

We are busy; we need more people; seems this money flowing out the door may be an answer for that.

 

Big non-profit in California.

 

-J

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On 1/14/2018 at 7:22 PM, AshleyJackson12 said:

Hi jwells78,

I read your post. You mentioned you are an employee of the hospital, that's why surgeons are not paying to you.

Thanks!!

 

It depends on how the physician contract is structured. Essentially both the PA and the surgeon need to be paid by the same entity. If the hospital is paying the physicians a salary and then billing for them they can bill for your services since both are employed by the same entity. Alternatively if they are given a stipend but then billing for their services then the hospital cannot bill for your services. In addition your assistance in managing their patients may be considered a Stark violation. In this case the surgeons can pay the portion of your salary dedicated to their patients and then bill for your services. 

Don't forget for Trauma you can also bill critical care if indicated. Contrary to whats posted above you should not be included in the hospitals cost report. Prior to 1998 PAs were included in the cost report but after 1998 with the ability to bill for our services Medicare rules state the hospital must bill for your services. 

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1168CP.pdf

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