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We are a multi-specialty clinic and are on the edge of a revolt with some of our specialists. They do not want to be listed as the responsible provider within EMR. In years past, we changed the field from Primary Care Provider to Responsible Provider in an attempt to be sensitive to the fact that they are not truly the patients PCP but to also display the physician that is treating the patient display on the patient banner. This is no longer a satisfactory solution for them. I am attempting to compile a list of pro/cons for this issue as well as looking for solutions other clinics may have found to work around this problem.
What would happen (or what would we break) if we did enter “None” in the field? The only real downside that I have identified so far is that any inquiry we do would have to be based on appointment book or signature line.
All thoughts, suggestions, opinions or ideas will be appreciated. Please respond to [email protected] if you do not want to post here.
Debbie
Posted : December 27, 2016 5:28 am
Simple:
Patient.PCP--the PCP. Patient.RespProvID--physician in clinic responsible for care in the specialty clinic. Change your banner to include both.
Posted : December 27, 2016 5:50 am
Debbie,
I would need to understand more about your workflows and your organizational structure before making any recommendations. Generally speaking, the "Responsible Provider" that is identified under Patient Registration is the individual that claims will be filed under unless it is overridden when the encounter document and/or orders are signed (which probably happens in a multi-specialty clinic). That said, putting "None" in for the "Responsible Provider" field under Patient Registration is not a good option. In fact, the only way you could do that is to set up a fake provider in your clinic called "None."
Under patient registration, you have a PCP, a Responsible Provider, and a Referring Provider. In a specialty clinic, I would think that your patients are being referred by their PCP which would make that individual the PCP AND the Referring Provider under patient registration. Under this scenario, it would be best to list your specialists as the Responsible Provider under patient registration because the claims (presumably) would be processed under their name. However, if your practice employs PCPs and they are referring the patient internally to a specialist, then you might consider a different setup. Specialists can still be tied to the patient by listing them as contacts for the patient. This gives you a way of consolidating the patient's "care team members."
Something else to keep in mind is that the "Responsible Provider" for the patient and the "Provider" for the document are separate concepts. I've seen others get tripped up by this idea. The "Responsible Provider" is tied to the Patient Registration record, while the "Provider" for the Document is tied to a specific document that was created for the patient (think of it as the Author of the document). These don't necessarily have to be the same and often aren't. It sounds like your physicians may be getting all worked up over a semantics issue with how their name appears in the patient banner. If that's the case, you have a couple of options:
- Leave them as the "Responsible Provider" under Patient Registration and create your own custom banner as already suggested. Instead of using a label in the banner that reads "Responsible Provider", rename it to something like "Provider." I have an example I could share if you were interested. (this is probably what I would do if you have PCPs external to your organization referring patients to your clinics)
- Don't display the "Responsible Provider" field in the banner at all. If they want their name to appear in the document they are creating, there are any number of ways to do that, the most common being the insertion of an electronic signature. I suppose you could also build a custom form in your encounter template to identify the specialist and display their name somewhere on the form; in that case, use the {DOCUMENT.PROVIDER} symbol because it sounds like what they are wanting to see is the name of the provider that saw the patient rather than the individual that's listed as the patient's Responsible Provider.
I'm guessing your providers are trying to make a connection between the patient banner and the encounter they are documenting for the patient, but remember the patient banner information is associated with the patient and not the encounter (or document being created for the patient). I'm happy to discuss this offline if you need some further guidance, but hopefully this points you in the right direction.
Posted : December 27, 2016 8:53 am
Debbie, are you on CPS or CEMR? The reason I ask is because our providers wanted to see the PCP name in the banner and if the pt didn't have a PCP, then they wanted to see "No PCP Selected".
We are on CPS 12 and they set up a billing provider accordingly. The only catch is this is loaded in the PCP in registration, it automatically defaults into the visit in billing so the billing staff have to take it out before filing the claim because it can cause filing errors.
Posted : December 27, 2016 9:50 am
@lkeith, we have conditional statements in our banner, so we don't have a provider called "No PCP Selected." In our case, the conditional statement is:
PCP: {if PATIENT.PCP = "" then "None" else PATIENT.PCP endif}
If there is no PCP defined for a patient, then the banner shows "PCP: None" otherwise it shows the defined PCP.
Perhaps this would make things a little easier on your billing staff.
Posted : December 27, 2016 11:01 am
We are a multi-specialty clinic as well and we don't use the responsible provider field, because it changes all the time. The patient can see 2 different specialist in the same day. We do add the patients PCP in registration, if they have one. You are correct on the Inquiry reports, but we have found other reports to meet our needs. Best of luck.
Posted : December 29, 2016 8:09 am
