A: Scribes only write what another person does. IMPORTANT: The term "scribe" DOES NOT APPLY when the person writing also performs professional services. The use of scribes is strongly discouraged and they may only be used when the term accurately applies.

A: Yes, but Medicare rules state the ARNP or PA may ONLY bill under their own number and cannot bill under the physician's number when either 1) performing a service on their own or, 2) for outpatient services only, when combining or splitting an Evaluation and Management Service (E/M) with a physician for: a new patient; a consultation; or an established patient with a new problem.

After obtaining the appropriate credentials, ARNPs and PAs must complete an application package furnished by the Faculty Group Practice. See your Departmental Administrator for an application package. Are the rules for combined/split services for inpatient and outpatient services the same? (Services where both the physician and the ARNP/PA see the patient).

According to COM policy, ALL ARNPs and PAs involved in any patient care activities MUST obtain both Medicare and Medicaid provider numbers.

All services may be performed and billed as long as those services fall within the scope of their practice.

Yes, for example, when an E/M service and a procedure are done on the same day, the modifier -25 would need to be attached to the E/M service. The modifiers should be used the same way a physician would use them.

Yes, as long as, (as with the physician), the service does not fall within the Medicare surgical global period. Medicare states that the global period begins within 24 hours of surgery. No, the ARNPs and PAs must be directly employed by the University of Florida or must have some other contractual relationship with the University.

No, ARNPs and PAs may also bill Medicare and Medicaid under their own billing (UPIN) number.Medicare now prohibits billing for the combined or split services of a physician and an ARNP or PA for outpatient E/M services for new patients, consultations, or established patients presenting with new problems in the physician's provider number. Our physicians are part of a group practice, and therefore, "cover" each other's patients.

ARNPs and PAs can bill for all code levels when billing under their own billing numbers It is suggested that the ARNPs and PAs consider carefully whether the required high level of medical decision making necessary to meet the standard for level 4's and 5's are within the scope of their practice. Either/or, which is the same rule for physicians. Please be aware, you may NOT combine the rules - you may not use sections of the 1995 rules with sections of the 1997 rules.

Current law limits a physician to supervising no more than two PAs at any moment in time. However, physicians who work in designated medically underserved areas may supervise up to four PAS. To find out if your physician is in a designated medically underserved area, please call the Committee office at (916) 561-8786.

According to the rules and regulations, one physician may supervise two PAs in an outpatient setting, four in a correctional facility, and six in a hospital setting. (see Article 131-B of the Law). What this actually means is subject to who is interpreting it, i.e. for example, in the outpatient setting does it mean two PAs total, or two PAs working at one time? NYSSPA has a letter from the DOH favoring the latter interpretation.

The College of Scribes is the umbrella term used to describe all of the members of the scribal community. Star Signet, Sable Scroll, and the regional scribes are all officers of the College of Scribes. The College is pretty loosely and informally organized - local guild heads, guild members, charter painters, and anyone else who is participating in the scribal arts can be considered a "member" of the College.

What a physician assistant does varies with training, experience, and state law. In addition, the scope of the PA's practice corresponds to the supervising physician's practice. In general, a physician assistant will see many of the same types of patients as the physician. Referral to the physician, or close consulting between the patient-PA-physician, is done for unusual or hard to manage cases and to ensure continuity of care by both the PA and the physician.

The PAS will include approximately 43,000 women and the purpose is to study their long-term health over 10 years. Physicians will be asked to participate in 3 follow-up visits over the course of the 10 year period after they perform surgery.

The typical applicant to a physician assistant education program has a bachelors degress and four years of health care experience. PA programs look for students who have a desire to study, to work hard, and to be of service. All PA programs are accredited by one independent organization supported by the American Medical Association, the American Academy of Family Physicians, the American College of Surgeons, and other national medical organizations.

The Department of Human Services will notify the Board of Medical Examiners of any deviations. If a formal investigation is warranted by the Board of Medical Examiners, physicians might be subject to disciplinary action.

Physician assistant salaries vary greatly, depending upon the locale, the specialty and the amount of experience the individual PA brings to the practice. Often, though not always, surgical practices pay more than primary care practices. Rural salaries are often as high or higher and salaries in large metropolitan areas because the demand for providers in rural areas may be greater. Salaries paid to PAs working in government agencies are often lower than those in private practice.

NPs and PAs can bill for Care Plan Oversight. The Medicare Benefit Policy Manual, Chapter 15, clarifies that nurse practitioners, physician assistants, and clinical nurse specialists, practicing within the scope of State law, may bill for CPO and outlines the requirements for billing. They are reimbursed at 85% of the physician rate. There is no requirement for the physician needing to see the patient in order to sign a 485.

The physician qualifications are consistent with the ACR Standard for Performing and Interpreting Computed Tomography, in effect January 1, 2002.