I have a question. As long as I've been practicing, I always will evaluate a patient in my office prior to scheduling them for a procedure in the hospital. There is this Ortho doc in my hospital that refuses to send me his epidurals (he has a huge volume) because I refuse just do the epidural without doing an eval on the patient. He has been telling other docs that I do the H&P before the procedure simple to "double bill" (although I get paid salary). So he sends his epidurals to another group who will do them no questiones asked. The other group has left the hospital and now he is raising hell that I won't simply do the epidurals at his demand. I've explained to him (very nicely) that I need to make sure that the patient is not on any blood thinners, the procedure is appropriate, etc. He says that that's his job. Moreover, it just seems smart for me to document something like a foot drop or something BEFORE the procedure so I can prove I had nothing to do with it. My question is...is it fraud to do a procedure without a documented H&P. The higher powers in the hospital are putting pressure on me to just do the epidurals and I'm not budging (the other group was doing epidurals on patients on Plavix). I need something to show them that someone (Medicare or anyone) requires an H&P in the chart from the physician prior to doing the procedure. Can anyone help me out? Thanks!