nurse vs. doctor--who should win?

[turquoiseblue]

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Medicare supposedly has a rule where billing can't be done for nurses and doctors who visit a patient at home on the same day. Me and a nurse saw the patient on the same day. Somehow a nurse called me on my personal number (don't know where she got it), and adamantly rudely told me she is billing the patient instead of my company i work for. the patient gets his meds from us, not her. the patient also has another physician but that physician for some reason doesn't prescribe the same meds as us and we see the patient once a month rather than every 3 months like a regular doctor, plus we make it so the patient doesn't have to leave their home if they are disabled. some patietns like to have a second doctor visit them at home every month.

what do you do when a nurse tells you they want to bill and not you and tries to make an argument that you're inferior to them because you only take 5 min to see a patient (i'm efficient and fast by training, thats why, i get all my work done in that time and spend time in the car preparing for the patient). i think all my other collegues are fast too.

is there a rule on this situation? just curious. should a nurse be allowed to have the audacity to cancel our billing on the patient for the month and have her services billed? who gets to bill in this situation? i think we already billed though. lol...if so, too bad for her rude imposing self.

 

[gutonc]

So I guess you finally got your license then?

 

[J-Rad]

This isn't really a residency-related question. Seems like a more general healthcare-related topic. Moving to a more appropriate forum.

 

[turquoiseblue]

no didn't get my license yet. they are pending....
im working under a supervising doctor in the meantime...

 

[JaggerPlate]

"I'm better because I spend more time with patients, therefore I deserve the money" ... sounds like Noctor doctrine to me. I have 0 evidence here to back this up, but my guess is that you (if you guys can't both figure it out) should be the one to get paid. Have you told the doc/company you work for about the situation?

 

[gutonc]

no didn't get my license yet. they are pending....
im working under a supervising doctor in the meantime...

If the supervising MD didn't also physically see and examine the patient, you can't bill anyway so it's kind of a moot point.

 

[Winged Scapula]

As far as I'm concerned, whomever bills first wins.

(had this situation in the past, where radiology was also reading my intraoperative sonograms/mammograms and then dictating "surgeon read report in OR" but still tried to bill for it. Because I am passive aggressive, rather than saying, "hey you can't bill for something you didn't do", I have a habit of billing RIGHT as I finish the case [via my EMR which I can access from the OR], so as to prevent them from being paid. Not sure it works, but it seems to in my cases.)

Oh and yeah, its crap that whomever sees the patient longer should bill; that is not a criteria for billing.

 

[deleted87716]

The obvious solution is to not both go on the same day.

Barring that, I agree with WS...first come, first served.

You can't "cancel" another person's billing, by the way.

 

[turquoiseblue]

Thanks for the replies. it is a jungle out there, so knowing the rules helps.