Ask Your Physician Advocate

Question: If a receptionist is trained by the physician they work for to perform the duties of a medical assistant, is there anything wrong with this from a professional liability standpoint?

Answer: As long as the physician has documented the required hours of training as defined by the Medical Board of California and has this employee covered in their professional liability coverage policy, there is nothing wrong with having your receptionist perform the duties of a medical assistant. For further information on medical assistants, see the “Risk Management Tip” below.

Question: If I were to drop my Medi-Cal contract but still see Medi-Cal patients in the emergency room, can I bill my usual and customary rate or will I still be limited to Medi-Cal rates?

Answer: If you are no longer contracted with Medi-Cal, you can bill your usual and customary rate. Keep in mind that if you are currently contracted with Medi-Cal, and you decide that you no longer want to be contracted with them, you need to take the appropriate steps to cancel your contract. You cannot begin to bill your usual and customary rate until Medi-Cal has communicated to you that you are no longer a contracted provider. This may take up to six months, and you may need to make some phone calls to follow up with them.

Question: If we decide to purchase an e-prescribing module, will we really be paid 2 percent more on all Medicare claims through our local intermediary in 2009?

Answer: CMS has yet to develop specific guidelines for the e-prescribing incentive. We at SDCMS will be working closely with Palmetto (local intermediary) to monitor CMS’ progress. As soon as these guidelines are made available, we will promulgate them to our member physicians.