Endo billing

[Iamnew2]

Hey all,
Question for those of you who are endocrinologists.
Spouse is currently finishing up his stay at LTACH after ICU admission
Diabetic, normally was very well managed
Anyhow, primary doctor consulted pretty much everyone including Endocrine. Endocrine doctor saw him 1-2 times and then reviews his chart, and bills for encounters without seeing him. Says he sees him but doesn't. Is this legit?
Do Endocrine docs bill without seeing patients/is that allowed? Thanks!

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[rokshana]

Hey all,
Question for those of you who are endocrinologists.
Spouse is currently finishing up his stay at LTACH after ICU admission
Diabetic, normally was very well managed
Anyhow, primary doctor consulted pretty much everyone including Endocrine. Endocrine doctor saw him 1-2 times and then reviews his chart, and bills for encounters without seeing him. Says he sees him but doesn't. Is this legit?
Do Endocrine docs bill without seeing patients/is that allowed? Thanks!

No…just like everyone else you have to lay eyes on the pt to bill
The only exception is an inter professional consult.. which requires that you don’t see the patient…it’s a formal discussion between the endocrinologist ( anyone can use it) and the consulting physician for advise on a question which does require further management or work up. They do need to state in the consult that it is an Interprofessional consult that was requested by Dr. X…
But how do you know that they didn’t come see your spouse? I know I round pretty late on hospital pts, anmd a lot of people don’t see me. Also with just sugar control, I may just pop in, say hi how are you doing? and not a really long visit… because seeing the pt for this usually isn’t really even necessary except for the billing part.

 

[Iamnew2]

No…just like everyone else you have to lay eyes on the pt to bill
The only exception is an inter professional consult.. which requires that you don’t see the patient…it’s a formal discussion between the endocrinologist ( anyone can use it) and the consulting physician for advise on a question which does require further management or work up. They do need to state in the consult that it is an Interprofessional consult that was requested by Dr. X…
But how do you know that they didn’t come see your spouse? I know I round pretty late on hospital pts, anmd a lot of people don’t see me. Also with just sugar control, I may just pop in, say hi how are you doing? and not a really long visit… because seeing the pt for this usually isn’t really even necessary except for the billing part.

Because my husband told me that he hasn't seen Endocrine in about 5 days - so I asked the Endocrinologist who called me so I asked her, and she says, well no we haven't seen him in person but we talk to the nurse about his blood sugar levels - he has questions for them and they can't answer them because they don't see him in person - but do write notes and I assume will want to bill.
yes I agree that the visit is not going to be super long in endo, but not seeing him in 5 days seems problematic. he has a bunch of questions for end and they won't see him for days until next week either - I'm like what the crap?
they gave him over twice the insulin he was taking at home so of Course he tanked and he wants to use his pump - but they won't let him so he's upset and they won't see him in person.
So to answer your question that's how I know - yes I'm aware that some docs might round late. he sees the other docs even if they round late

 

[rokshana]

Because my husband told me that he hasn't seen Endocrine in about 5 days - so I asked the Endocrinologist who called me so I asked her, and she says, well no we haven't seen him in person but we talk to the nurse about his blood sugar levels - he has questions for them and they can't answer them because they don't see him in person - but do write notes and I assume will want to bill.
yes I agree that the visit is not going to be super long in endo, but not seeing him in 5 days seems problematic. he has a bunch of questions for end and they won't see him for days until next week either - I'm like what the crap?
they gave him over twice the insulin he was taking at home so of Course he tanked and he wants to use his pump - but they won't let him so he's upset and they won't see him in person.
So to answer your question that's how I know - yes I'm aware that some docs might round late. he sees the other docs even if they round late

Do they talk to him over the phone? Are they billed notes done that five days or just informational notes…I write notes practically every day, just to document any changes, but they aren’t always billable notes…I document those as informational and have no time mark on them ( I bill by time) . I dont always see all the pts on our inpt list, but do tell the pt that if they have any questions or concerns, to let the nurses know and they can get in contact with me.
Not sure why they wouldn’t restart his pump if he is capable of managing his pump and can adhere to a pump contract while inpt. Frankly, I’m happy if the pt can go back on their pump …easier to control and many times i can sign off.

 

[Iamnew2]

Do they talk to him over the phone? Are they billed notes done that five days or just informational notes…I write notes practically every day, just to document any changes, but they aren’t always billable notes…I document those as informational and have no time mark on them ( I bill by time) . I dont always see all the pts on our inpt list, but do tell the pt that if they have any questions or concerns, to let the nurses know and they can get in contact with me.
Not sure why they wouldn’t restart his pump if he is capable of managing his pump and can adhere to a pump contract while inpt. Frankly, I’m happy if the pt can go back on their pump …easier to control and many times i can sign off.

No they don't - they have him once or twice and that's it. They talk to the nurse only otherwise.
That's why he's so pissed - he's had DM 30 years + and he's super well controlled on his pump - he's super unhappy that they don't see him and then tank him blood glucose wise gven that they put him on twice what he's normally on and refuse to allow him to use the pump. it seems a very billing focused place. his thought is as he tells me that they want to continue billing him without seeing him which is frustrating. we have had a lot of unpleasant healthcare experiences lately with a number of physicians.
thank you for your input!