Abstract

Teaching physicians are paid by Medicare Part B on a fee-for-service basis, but if a teaching physician does not participate in a given patient service or document this participation properly, the teaching physician cannot legally bill Medicare for these services. In fact, Medicare has severely fined academic practice plans that lacked such documentation [ 1 University of North Carolina HospitalsCoding and compliance. http://www.med.unc.edu/credentialing/OnlineCredentialingRadiology.ppt Google Scholar ]. Such documentation is also felt to be a requirement for other federal and state agencies as well as private insurance companies and other payers, and it is a common practice for academic medical centers across the country to require such documentation from their teaching physicians [ 2 Centers for Medicare and Medicaid ServicesPub 100-04 Medicare claims processing: transmittal 811. http://www.cms.gov/transmittals/downloads/R811CP.pdf Google Scholar , 3 University of North Texas Health Science Center, Office of Regulatory ComplianceClinical documentation & compliance manual: a guide to documentation, coding, and billing of medical services for compliance. http://www.hsc.unt.edu/policies/QuAssure/Clinical%20Documentation&ComplianceManual042704.pdf Google Scholar ].

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