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Name of SP on all billing documents?


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This is posted for "a friend"

 

A new EMR has been implemented recently, and when she is done seeing a patient, the chart is repopulated with the name of her SP as being the provider. The PAs name is still on the chart, and has her electronic signature, but the "provider" in the billing section is her SP.

 

She was told this is necessary because all of her visits are charged under the SPs name, but on many occasions, she sees patients without her SP being "in house". Sometimes they are completely new "walk in" patients or established patients with an acute issue. She works in an UC attached to a private practice.

 

Does this sound legit or should she be concerned? Obviously, further questions about this at work would probably be met defensively.

 

Thoughts?

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Guest Paula

She might have cause for concern if all her visits are billed incident to and the physician is not in house at all times. Incident to billing is for medicare (I believe it's medicare, not medicaid) and if the physician is not there, it is illegal to bill that way. She, the physician and the practice could get sued big time if they were ever audited.

 

She should demand that her billing is done under her NPI number, except where insurance companies require the SP be listed. Check state laws, her state PA chapter and AAPA should be able to help her out on this one.

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