quitman263 Posted November 7, 2014 Share Posted November 7, 2014 We have a physician in our practice that is a year out of residency. He feels that if he has to sign off on my charts he should get full credit for all my RVUs. At this time, I work in a clinic three days a week alone, he works with me the other 2 days. Can he get credit? I do all the work, every once in a awhile I ask his advice. He never even sees my patients. Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted November 7, 2014 Moderator Share Posted November 7, 2014 Maybe that 15% he's entitled to if he goes to see the patient as well. Otherwise, no. Also, is he a practice partner? Link to comment Share on other sites More sharing options...
quitman263 Posted November 7, 2014 Author Share Posted November 7, 2014 Thanks! He is not a practice partner. We are owned by a hospital system. Link to comment Share on other sites More sharing options...
gbrothers98 Posted November 7, 2014 Share Posted November 7, 2014 Yeah....no. He gets the RVU if he does work, not just for signing. Also has to consider if he has to sign every chart of yours according to state statute or is this just personal preference because he has not supervised PAs in the past? Talk to the business manager or the head of the practice about this. Good luck. G Brothers PA-C Link to comment Share on other sites More sharing options...
winterallsummer Posted November 7, 2014 Share Posted November 7, 2014 Hell no. I would go to supervisor. Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 7, 2014 Moderator Share Posted November 7, 2014 NO you do the work you get the credit Should he get a tiny % for supervision - maybe Link to comment Share on other sites More sharing options...
Acebecker Posted November 7, 2014 Share Posted November 7, 2014 This doc sounds like a joke. The answer is no. Link to comment Share on other sites More sharing options...
dereasy Posted November 7, 2014 Share Posted November 7, 2014 I've always wondered about this...so in my ER all of my charts have to be signed by my attending, even level 4's and 5's (though that is changing soon). So I will typically see the patient, do my full H/P, labs, a/p, most of my attendings typically pop in the room for a quick minute to say hello and some wont see them at all but at the end of my note they all put something like: "I saw the patient with the PA, patient presented with chest pain, I made all diagnostic treatment and dispo decisions" Does this enable them to get full rvu credit? Does that take anything from me? Link to comment Share on other sites More sharing options...
delco714 Posted November 8, 2014 Share Posted November 8, 2014 He has to do his own exam and meet the patient even briefly to get billed under his name.. then he needs to establish the assessment and plan. I do consults all day, most of them the doc isn't around,I get the rvu. I'll do a note every so often when I see one with them, or they'll do their own. Link to comment Share on other sites More sharing options...
Guest Paula Posted November 8, 2014 Share Posted November 8, 2014 I've always wondered about this...so in my ER all of my charts have to be signed by my attending, even level 4's and 5's (though that is changing soon). So I will typically see the patient, do my full H/P, labs, a/p, most of my attendings typically pop in the room for a quick minute to say hello and some wont see them at all but at the end of my note they all put something like: "I saw the patient with the PA, patient presented with chest pain, I made all diagnostic treatment and dispo decisions" Does this enable them to get full rvu credit? Does that take anything from me? This borders on fraud when the physician doesn't see the pt. It's all about the money and billing. When the physician "pops" in they can bill under the physician fee. You should ask about this....is this fraud....and will I lose my license? If they bill under the physician how are your credited? I would want to know. Just be prepared when you start questioning the system and get educated that they might think you are a trouble-maker assistant. Link to comment Share on other sites More sharing options...
delco714 Posted November 10, 2014 Share Posted November 10, 2014 Paula, it is definitely fraud if the doc never actually saw the pt Link to comment Share on other sites More sharing options...
JohnFerguson Posted November 11, 2014 Share Posted November 11, 2014 How many wRVU's are typical for a surgical PA working in the office setting and first assisting? Link to comment Share on other sites More sharing options...
gbrothers98 Posted November 12, 2014 Share Posted November 12, 2014 I've always wondered about this...so in my ER all of my charts have to be signed by my attending, even level 4's and 5's (though that is changing soon). So I will typically see the patient, do my full H/P, labs, a/p, most of my attendings typically pop in the room for a quick minute to say hello and some wont see them at all but at the end of my note they all put something like: "I saw the patient with the PA, patient presented with chest pain, I made all diagnostic treatment and dispo decisions" Does this enable them to get full rvu credit? Does that take anything from me? This is fraud. You wont get the full credit, essentially these docs are taking credit for all the medical decision making being done by them, when it appears you likely are not. Likely they are getting the bulk of the RVU for these encounters. Not a great working environment. They completely understand what they are doing. They are screwing you. GB PA-C Link to comment Share on other sites More sharing options...
FBIDoc Posted November 12, 2014 Share Posted November 12, 2014 I would turn it on him and ask him for RVU credit for the two days he's on...see how the douche replies... Link to comment Share on other sites More sharing options...
dereasy Posted November 12, 2014 Share Posted November 12, 2014 This is fraud. You wont get the full credit, essentially these docs are taking credit for all the medical decision making being done by them, when it appears you likely are not. Likely they are getting the bulk of the RVU for these encounters. Not a great working environment. They completely understand what they are doing. They are screwing you. GB PA-C Hmm very interesting. Don't all PA charts have to be signed by an attending though no matter what setting? I do present all of my higher acuity patients to the attending so it's not like they're signing the chart completely blind on the patient. Link to comment Share on other sites More sharing options...
gbrothers98 Posted November 12, 2014 Share Posted November 12, 2014 Hmm very interesting. Don't all PA charts have to be signed by an attending though no matter what setting? I do present all of my higher acuity patients to the attending so it's not like they're signing the chart completely blind on the patient. No. Depends upon setting and state statute. My state statute stipulates a representative percentage of charts need to be reviewed and cosigned. That percentage is decided upon locally. Telephone contact with SP is the minimum standard according to state statute also. Clinics and hospitals can set their standard higher if they desire. Many PAs (and their SPs) operating under myth and dogma out there. And when your SP signs all your charts, 5 days, 20+ patients a day, what does that really provide? He/she is actually reading line by line every chart? Uh huh. My SP reviews and signs all charts. He does this as a risk management and quality assurance tool. He signs remotely and usually much after the fact depending upon when chart is completed and sent electronically for review. One could also say it justifies his position and makes our group look good too. But it is unlikely he is reading every chart completely. What does your state PA statute stipulate as the requirement? GB PA-C Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 12, 2014 Moderator Share Posted November 12, 2014 Hmm very interesting. Don't all PA charts have to be signed by an attending though no matter what setting? I do present all of my higher acuity patients to the attending so it's not like they're signing the chart completely blind on the patient. absolutely not! no cosign in out patient in my state - none, nada, zip admit and dc orders need cosgin - otherwise we are on own..... Link to comment Share on other sites More sharing options...
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