How do we determine if a medical patient is new or established? The decision is ultimately made based on the professional service they were given during their visit. Read more to learn how to recognize the differences between a new patient and an established patient when COVID-19 testing.
In the June 29, 2020 edition of Part B News, A really great question was submitted. To summarize, there is a clinic that has been doing COVID-19 testing. A person comes in, fills out a few forms, and then receives the test. When results are ready the patient will come back to the clinic and especially if the patient’s results are positive will see a doctor. Would this patient be considered a new or established patient for the visit with the doctor?
This is a great question that is really important with more and more tests being conducted in all 50 states. In order to answer this question, we need to evaluate the testing. Was this patient seen by a doctor who evaluated them for the need for a test? If this is that case then this patient received professional service with a physician or other qualified health care professional (QHP) and is now an established patient.
Or is the testing completed by a laboratory tech, nurse, or medical assistant (MA), and the patient never sees a physician of QHP? If so and there was no “professional service” then when the patient comes back for their results and is seen by a doctor then this would be considered their first professional service and therefore would be a new patient. It all comes down to a matter of the “professional service” and if the patient has had a face-to-face encounter with a physician of QHP in the past.