Re: Building office relationships (related to codes)

[Guest guest]

Lea,

It is

important to meet the criteria of federal and your own state’s Medicaid

regulations with regard to incident-to billing. Make certain the contract

relationship you are describing legally defines you as a “direct

financial expense”: See attached article.

“Your Office

In

your office, qualifying “incident to” services must be provided by

a caregiver whom you directly supervise, and who represents a direct financial expense

to you (such as a “W-2” or leased employee, or an independent

contractor).”

Also,

I think it would be imperative to be in clinic tosee patients at least 2 days a

week to provide good follow-up care. An entire week is very long between lactation

management plans. I usually see my patients in the peds practice who are having

problems within 2-3 days after the first visit and depending on improvements

another (3rd) visit in less than a week. I have found over the years

that things are changing quickly at this time and the management needs to be

adjusted. Also, if you don‘t follow closely Mom can get discouraged and give

up much more easily. Additionally, how will you do phone follow-up or how will

the patient access you the other 6 days a week. My office manager insists that

all work I do for the office is “paid time” as an employee and very

often patients need phone support which cannot wait a week. I am not sure if

this is a regulation or just what they want, but I do go into the office even

if just to make follow-up phone calls on some days when there are no patients

scheduled.

Judy

Judith

L. Gutowski, BA, IBCLC, RLC

135 McGrath Lane

P Box 1

Hannastown, PA 15635-0001

Cell

Phone

Fax

1 of 1 File(s)

Incideent to article cms mln matters article.pdf