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depends on whether you are going to drop a bill and if the shift they are working is being considered as a fellowship shift or a moonlighting shift.  
If the fellow is licensed and credentialed to be on the medical staff. then they can be credentialed by the various payers. So if they precept residents when they are not working as fellows but "moonlighting", they can write an attending note and a bill can be dropped.
If they are working as a fellow, they are treated as a resident in the eyes of the payers, they would still need an attending statement to be made, whether or not the resident or fellow made notes. 

Marty
Martin Herman, M.D.

Pediatric Emergency Medicine 
Sacred Heart Children's Hospital

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> Date: Mon, 17 Nov 2014 09:49:51 -0500
> From: [log in to unmask]
> Subject: Fellow's documentation
> To: [log in to unmask]
> 
> 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.  
> 
> Thanks,
> 
> Christopher Kelly MD
> Chief, Division of Pediatric Emergency Medicine
> New York Methodist Hospital 		 	   		  
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