Healthcare Financial Services
Physician supervision of any patients under home health (or hospice) is called Care Plan Oversight (CPO). These patients receive complex healthcare that requires a physician to be involved on an ongoing basis. CPO is not covered for patients in a skilled nursing facility (SNF) or other nursing facilities, only hospice and home health.
Telemedicine visits are doctor visits for either new or established patients, only they take place on some type of live virtual platform instead of in person. The healthcare industry is beginning to more readily accept this type of doctor visit, but the billing requirements can be confusing, and reimbursement varies.
The medical history of a patient is one of three principal components required in determining the level of the encounter and the status of the patient (new or established).
The definitions of new or established patients relate to services from a physician or qualified healthcare professional licensed from the same specialty and subspecialty in the same group practice.
Inpatient billing can be confusing.
The first aspect to understand is that it is not based on the status of the patient. New or established status does not apply to inpatient billing codes, as they are used for an initial doctor visit, whether the practitioner has an established relationship with the patient.