We began Professional Fee Billing in the residency clinic starting in July, 2020. Up until now, billing has been handled as a hospital service. Pro Fee billing is a way of more accurately capturing reimbursement for services we perform. This industry standard also will help residents address their learning need for business skills required when they become employed as physicians upon graduation.
Dr. Dayal asks that all residents and faculty be aware of the following Key Points regarding our Pro Fee Billing:
This will be mailed out as a weekly assignment schedule and posted in the IMC.
This usually occurs briefly after the resident has staffed the patient. As we increase the number of staff faculty over the next few months, they will be available to enter more senior resident rooms as well.
Remember those EL4 or NL3 buttons we click randomly? Well, now they mean something. The Tip Sheets available on this page will help you decide which Level of Service to choose for your visit. On the most basic level, if the attending didn't see the patient, it's probably an EL3. If the attending did see the patient it's probably an EL4, as long as you addressed at least three problems during the visit. This is a huge generalization but it will help us hit the ground running. Ask an attending if you aren't sure! (Notes billed incorrectly will start to show up in the faculty boxes for to be corrected so it's best to get it right the first time.)
Both the resident and the attending have to sign the note before it can be billed.
It doesn't have to be exhaustive, but preparing for clinic and telling your attending what you expect before hand leads to a much smoother clinic day!
Our lead team has visited clinics where're-fee billing is already in place. We realize this represents a big change, especially for how we train PGY-1's, but all our PGY levels will be affected. It will allow for more direct observation, make the IMC less intimidating for PGY-1s who are just trying to figure things out and create a more collaborative working environment in the IMC.
Working in any ambulatory setting requires learning the workflow and how to make the system work for you and your patient. In this series of videos, our faculty shares their expertise designed to strengthen your ability to prepare, conduct and document an ambulatory visit efficiently. Whether you are an intern on IMC month or a senior preparing for practice, you will glean new practical tips from each video.
Summa Health System is located in Northeast Ohio. It's multiple campuses serve as an academic community teaching resource for the Northeast Ohio Medical University and hosts 11 residencies and 7 fellowship programs.
