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multispecialty responsible provider issues

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Last Post by ntaylor 10 years ago

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plittle

(@plittle)

Posts: 19

Eminent Member

Topic starter

Wondering if anybody knows how the responsible provider in the registration works when you have patient's seeing multiple specialties within the practice. We have family practice, internal medicine, Gastro, Surgeons etc. Some times a patient may be seeing multiple doctors in the group. If they have a primary care physician within our group we have a cascade of issues which seems to stem from the changing of the responsible provider to a specialist when they are seen.

So say a patient sees a surgeon currently when they arrive the front desk changes the responsible provider from the internal medicine doctor (who is their primary care provider) to the surgeon. Many times the responsible provider doesn't get changed back to the primary care provider. There seems to be confusion about when and if the changing of the responsible provider should happen. However, so many things seem to be affected with this change. For instance if the change isn't made for the provider who is seeing the patient and they order labs or medication then the Headings appear to be from another clinic (many of our clinics don't share the same address, or Clinic name). The CVS will have the primary cares Clinic name address etc.

The current suggested work flow is when a patient leaves the clinic and checks out the front office staff should change the responsible provider back to the primary care provider. But our lab interfaces seems to be linked to the responsible providers also. So if the surgeon or specialist orders labs will be routed to the primary desktop.

I don't know if this is making any sense. But if anyone has any insight I would appreciate it.

Posted : May 13, 2015 4:17 pm

acantu

(@acantu)

Posts: 722

Prominent Member

From my understanding you are not supposed to change the responsible provider every time they see another provider. For those issues you listed, you can change the information being displayed for the provider to the provider of the visit. And for the CVS header address, I believe that is based off of the location of care that is set for the visit. Now about your lab situation, i have to look into that, it might be just how your lab interface was configured. What lab interface are you using?

Posted : May 13, 2015 8:06 pm

dduschel

(@dduschel)

Posts: 207

Reputable Member

We are also multispecialty and we do not have our staff change the Responsible Provider for the patient. They used to, but it caused a bigger problem than it was worth. Being multi-specialty our providers wanted an easy way to know who the PCP was. We had to come up with a work around of putting the PCP in the Referring physician field so we could use that data symbol to pull into the banner calling it PCP. Many of our PCPs are out of our DB so we couldn't make them the Responsible Provider of the patient. I feel like this should really be changed/addressed by GE but I guess most places have come up with some sort of work around like we have.

Posted : May 14, 2015 2:14 am

plittle

(@plittle)

Posts: 19

Eminent Member

Topic starter

I don't think that the CVS is based on the location of care of the visit. Whatever the home location is in the registration at the time of creation of the CVS seems to be what the header will indicate. It would make more sense if it was linked to the location of care of whatever doctor was seeing the patient but some how it isn't. So when you say

"From my understanding you are not supposed to change the responsible provider every time they see another provider. For those issues you listed, you can change the information being displayed for the provider to the provider of the visit."

Are you just talking about when you go to open the encounter changing to the provider for that document. We were told that without changing the responsible providers in registration that it messed up things on the billing side.

Posted : May 14, 2015 3:28 am

trichards

(@trichards)

Posts: 58

Trusted Member

We are a multispecialty clinic also. After many many problems caused by the responsible provider field, we decided not to use the field at all. Our biggest problem was orders defaulting to the responsible provider instead of the ordering provider if the field was not changed in registration. So we have opted to LEAVE IT BLANK.

Posted : May 14, 2015 4:20 am

acantu

(@acantu)

Posts: 722

Prominent Member

We use our own custom CVS I built, sorry thought GE's version did. The only issues for billing that can occur is when putting the orders in and making sure the authorizing provider is not the provider that saw the patient that day. As you can see from trichards response, you do not even have to use it, you can adjust the documents that you print, except for the CVS, to show the provider being the provider for the visit.

Posted : May 14, 2015 4:55 am

ntaylor

(@ntaylor)

Posts: 79

Estimable Member

Hello,

We are also multispecialty, using CPS 12.6, and we do not use the Responsible Provider field in Registration either, and as Terri mentioned, we also train our staff to leave it blank.

We do use the Primary Care field in registration, and it can be pulled into the EMR banner by using the PATIENT.PCP symbol.

We also have our own internal lab department with an order interface to it. Our orders default to the Responsible Provider of the EMR document. I did look in Administration => User and Resource Management => Preferences => User Preferences = > Patient Charts => Order Entry and there is a setting for the 'Authorized By' field which may be the key to why our orders function the way they do. I have it set to "Responsible Provider of Document"

Also, under Administration => User/Resource Mngmt => Users => Locations of Care Printing Default I have "User's Current Location" select. This allows the printed header information to change to match the LOC information of the user who is printing the document. So as each department is printing information for a patient the header will print appropriately for that department, assuming the user is logged into the correct LOC.

I'm uncertain about the LOC on CVS. I haven't look at it in a while, because we have some other issues with the CVS data that we are waiting to get fixed.

One issue that we do have by not utilizing the Responsible Provider field in Registration, is that we cannot do Provider Specific Patients Inquiries in the Inquiry module, because the Responsible Provider field listed there is pulling from Registration. Even if we did use the RP Registration field, the Inquiries would not be accurate anyways, because it would only show us the data for the doctor who is currently in that field. We've mentioned this to GE multiple times and have asked that they add the Appointment Responsible Provider to the list with the other Appointment fields that are available.

Hope this is helpful.

Posted : May 14, 2015 7:40 am

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