While it is necessary for the resident to perform a Level 5 service, the attending cannot bill for that level. Therein lies the attending's challenge in documenting. When billing, physicians must keep in mind the level of service that the attending needed to provide, not necessarily what the resident or fellow must provide, since they are in a training mode. Also, the level of exam that is billed for should be clearly documented. Please remember that what is medically necessary for the patient is not always what is necessary for teaching.
Medical necessity determines the appropriate level of billing.
Updates on teaching physician billing guidelines will be featured regularly in Yale Practice . A new HCFA Compliance Committee has been formed with a faculty liaison from each Department. The Committee membership is listed on front page. For more information on the Guidelines, contact Diana Rogers at 5-2140 or contact your departmental liaison. There is a legal foundation to the MCO referral system.