new vs established patient

We are a multispecialty group with both internal medicine and family practice providing primary care. If a patient's pcp is internal medicine but not available that day, so they see a family practice provider, would that be considered a new patient, since technically it's a different specialty? These claims are all billed under the same TIN.....Any advice you can give me is greatly appreciated. Thank you!

Ilona "Cookie" Broadhead CPC, CIMC
TMC One Medical Group
520 324 2399



  • edited May 2017
    Technically it could be but since the FP doc is "covering" for IM doc I would not bill it as a new pt.

    Sent from my iPhone

  • Would be considered established since it is the same TIN and they are not being referred to a specialist within the practice.

    Lil Convery, CPC
    Office Manager
    HIPAA, OSHA Officer
    Credentialing Specialist
    Central Jersey Orthopaedic Specialists, P.A.
    1907 Park Ave; Suite 102
    South Plainfield, NJ 07080
    (P) 908-561-2122 ext 211 Fax 908-769-5308

  • ditto! I agree with Jan. This is one of those instances where just because you might be able to do something - it might not be the most ethical or right thing to do it.

    Don Self & Associates, Inc

    305 Senter Ave, Whitehouse, TX 75791
    903 871-1172 fax 480-247-5650 web:
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