Moderator EMEDPA Posted August 8, 2011 Moderator don't call yourself a scribe. say "case discussed with dr so and so who also evaluated pt and who agrees with assessment and plan" if that was the case. if they don't allow that I would quit. seriously. or tell the lazy doc to dictate his own note.
Moderator EMEDPA Posted August 9, 2011 Moderator Better to have to find a new job than to have to answer for fraud yup. pa's are not scribes. if that is what they want then let them do it without you. if enough pa's refuse to be treated like this they will adapt.
Guest pak8 Posted August 9, 2011 Unfortunately this forum has become unhelpful because of rude contributors
Moderator EMEDPA Posted August 9, 2011 Moderator probably loss of license and big fine. don't do it. you are not a scribe. you are a pa. if they want a scribe they should hire one.
wilso2ar Posted August 9, 2011 If the physician does not see and evaluate the patient then it can not be billed at 100% under medicare. I believe that there is shared visit that if the PA does all the work and the physician then sees the patient the combined time can be billed at 100%. this is the way that our backwards dying hospital does things. every inpatient must be seen by the attending physician every day (a few of us are trying to get this changed). I say dictated by___PA-C for Doctor___. Thankfully only about 3% of my total work is in the hospital. I love going to the hospital then my Sp follows me and puts his blessing on it...drives me crazy.
Guest pak8 Posted August 9, 2011 Shared/split cannot be used for billing a first visit for new inpatient consult. it's either PA at 85% or doctor at 100%, no combo
wilso2ar Posted August 9, 2011 Just found this on my state's site " As of January 2, 2006, inpatient and outpatient consults for Medicare patients have to be billed by the person doing the majority of the work. CMS will no longer accept consults billed as “shared care” visits. Inpatient H&Ps and subsequent day visits may still be billed as "shared care" visits." learned something new today. So if a PA is doing the majority of the work then it better be billed under the PA.
Contrarian Posted August 9, 2011 ... so there's no way I'm going anywhere any time soon... Except maybe to prison for fraud...
Moderator EMEDPA Posted August 9, 2011 Moderator Ok wise guy so what would you do in my shoes? New grad, knows nothing about anything, just googled this scribe stuff last week.... UM, not take a CRAPPY JOB IN THE FIRST PLACE MAYBE....
Contrarian Posted August 9, 2011 Ok wise guy so what would you do in my shoes? New grad, knows nothing about anything, just googled this scribe stuff last week.... Ok... since you asked... Well first, I would have ensured that I had significant, paid direct healthcare experience in a position with extensive exposure to the various roles on healthcare teams BEFORE I even applied to a PA program. I would have also made sure I had been exposed to enough direct patient care and healthcare teaching before PA school so as to not need to take a "medical abbreviations" class to start PA school... and I would have paid attention atleast long enough to understand what the word "scribe" means so when someone tried to make me one... after I had invested the time and energy to become a MEDICAL PRovideR... I would be smart enough to know thats NOT what I just invested my blood, sweat and tears to become and would adamantly decline the suggestion, offer, insistance that I act as one. I would be too afraid of the slippery slope and fear being treated and expected to act as the "custodial engineer" next week. As a student of human behavior, I'd also be concerned that after a minimization of role, a minimization of contributions to the overall effort usually follows... then a minmization of pay and respect seals the deal. I would have and remain to out right REFUSE to commit fraud. See because as a CNA, EMT-B/I/P, PCT, LPN, RN and now FNP/PA-C... I was ALWAYS taught that NO ONE will protect my license as well as I will/should. But hey... that's just me... There's a LOT more I could add... but I figured I'd break you in easy... since you are new... and the boys down at the prison like em when they think they are smart/educated and with a little fight left in em... Wait till them fellas in cell block #2 find out that you working as a "scribe" in UROLOGY basically to them means that you fondled "johnsons" all day... they're gonna love you...:heheh:
Contrarian Posted August 9, 2011 I am of the opinion that the proliferation of PA Programs and the resultant habit of those programs spewing new grads like widgets leads to this type of thing being normal and acceptable to those who didn't invest much into gaining entrance into this profession. Hell... if I didn't have to do anything but watch someone work, copy a essay, and go on a job interview... then why should I care that some doctors are willing to pay me $70k to act and perform as a super MA or highly trained LPN...??
Moderator EMEDPA Posted August 9, 2011 Moderator i am of the opinion that the proliferation of pa programs and the resultant habit of those programs spewing new grads like widgets leads to this type of thing being normal and acceptable to those who didn't invest much into gaining entrance into this profession. Hell... If i didn't have to do anything but watch someone work, copy a easy, and go on a job interview... Then why should i care that some doctors are willing to pay me $70k to act and perform as a super ma or highly trained lpn...?? word..........
ToppDog Posted August 9, 2011 Two weeks is not long enough to look like a huge gap in unemployment. Tell them you won't do it, & if they fire you, they fire you. Even as an MA I have refused to do things I knew I was not allowed to do. Yeah I got fired for it, but within a year or two the place got shut down, & the providers that didn't flee to another country went to jail. And, that was before they really started cracking down on fraud. You're not some lackey employee that can get away with saying you were just following orders anymore. Walk away now & you can read about them all going to jail over coffee some day in the future.
Administrator Banuchi Posted August 9, 2011 Administrator @pak8 RE: Reason: Unfortunately this forum has become unhelpful because of rude contributors First of all, just because one person out of over 40,000+ members was rude to you, you don't have to bash my forum. The forum IS helpful, and I have thousands that would disagree with you. If you can't take it, then you will have a very difficult time in practice. When you get a rude patient, will you quit practicing? You need to learn to ignore the comments which you find don't contribute to your question and move on, otherwise you are in for a rude awakening.
Contrarian Posted August 9, 2011 Typical... What you seem to fail to recognize and realize is that the reason you are getting empassioned replys on this subject is because in practice... you set precedent and EVERY PA who follows you in that practice, or the one down the street will have to deal with being expected to perform as a "scribe" because those PAs at that practice allowed themselves to be utilized as such. Its a "two steps forward... one step back" sort of thing whenever we gain some ground, recognition and acceptance as medical providers/professionals that is then immeadiately undermined by desparate PAs who simply "want a job" and couldn't care less about the struggles those who came before them endured to set and elevate the professional standards of practice, performance, respect and renumeration that is common place now. As for the "rude" comments... Everyone offered sincere, clear and respectful opinions until YOU came back with the "WISE GUY" remark and asked what we would do... YOU opened the door for that and now you want to play the victim... yeah ok. It appears that maturity isn't a strong suit... which is also ANOTHER reason why those physicians want to restrict you to a "scribe" role.
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