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GEN: splitting Ob package c FPsFrom: Arthurfree (Arthurfree@aol.com)Tue Dec 9 22:41:36 1997
In a message dated 97-12-09 11:05:45 EST, you write: << Then once the delivery occurs, if more than one person is involved, they can split it as is appropriate. R. Daniel Braun, MD FACOG >> This is perfectly legal if both physicians are within the same organization (i.e. multispecialty clinic) and it is the internal disbursement of income that is occurring. Fee splitting of any sort is completely illegal between independent entities. Each physician must then bill for the component of care he or she provided. Most insurance companies do not pay for prolonged detention codes for labor management. Sometimes kinder obstetricians will charge for the consult they dictate and not the delivery code when they do an operative delivery (thus letting the physician who managed the labor bill the delivery code). That option is not available when it is a csection as there is a very definite surgeon of record (and it is probably skating on the edge even in the first example). The way the codes and reimbursement are set up, there is frequently no recourse for the provider who managed the labor (i.e. all they can bill for is for antepartum care) except to try billing for an H and P and using prolonged care/detention codes. Third party payors are keyed into using the global codes and usually do not cotton well to this approach even though the care is often very well documented. Arthur Freeland Warrensburg Missouri
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