It doesn't matter if the fellow is on the medical staff or not. If the fellow is working a fellow's shift then they fall under the resident teaching physician rules and the attending physician needs to document the appropriate attestation in order to bill the service. Some state Medicaid programs will allow fellows to bill for their services (not requiring an attending's note) but the majority follow the Medicare TP guidelines.
If the fellow is on a moonlighting shift as a pediatrician then they may bill independently.
Jeffrey Linzer Sr., MD, FAAP, FACEP
Professor of Pediatrics and Emergency Medicine
Emory University School of Medicine
Associate Medical Director for Compliance
EPG/Division of Pediatric Emergency Medicine
Lead Physician, ICD-10-CM Transition Core Leadership Team
Children's Healthcare of Atlanta
From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Christopher Kelly
Sent: Monday, November 17, 2014 9:50 AM
To: [log in to unmask]
Subject: Fellow's documentation
Question for the group. How do you deal with documentation by felllows when they are precepting residents. Do you have three separate notes? 1 by resident, 1 by fellow, 1 by attending? Do you have an abbreviated format? How does this affect billing? We are trying to streamline the process without having three complete and potentially contradicting notes. Any help would be appreciated.
Christopher Kelly MD
Chief, Division of Pediatric Emergency Medicine
New York Methodist Hospital
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