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Resp Provider vs Primary Care vs Referrinig

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Last Post by tippenring 5 years ago

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cliffstark

(@cliffstark)

Posts: 194

Reputable Member

Topic starter

Can anyone give a good explanation as to what these fields impact in registration?
In the past, we've only user the Responsible Provider field however, there is some confusion at our organization I would like clarification on. What impact do these fields have in billing, scheduling, reporting, etc? Any insight would be greatly appreciated.

Thank you!

Posted : January 29, 2020 4:44 am

tippenring

(@tippenring)

Posts: 56

Trusted Member

I'll provide my take on it, which comes primarily from my experience with HL7 and billing.

Responsible Provider is the billing provider. This is the provider in the practice that is providing or managing services provided to a patient. This often causes issues in multi-specialty practices where patient's can be under the care of multiple providers of the same practice at the same time.

Clinically, the referring provider is used so the resp provider knows who to send their notes to. It seems the billing process sometimes requires a referring provider, but I'm not familiar with why that is.

Primary care I think is intended for situations where a patient has a PCP overseeing and coordinating all of their care. Clinical notes usually also are sent to the PCP, but AFAIK billing does not care who the PCP is unless the PCP is also the referring.

So, the conditions change depending on your use case. If you use Centricity in a primary care setting, that will be different than if you're using it in a specialty setting.

-dp

Posted : January 29, 2020 5:02 am

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