Question
I am supervising a 4th year Au.D. student, but sometimes have to travel to different office locations. During these times, other audiologists in my office supervise the student. When the student performs testing under the supervision of my colleagues, should we bill under whomever is supervising the student while the testing is being conducted, or should we always bill under me, since I am the supervisor on record with the university?
Answer
Medicare has the attitude that it is paying the licensed audiologist for the service and not the student. It will let the student participate in the service but with 100% over-the-shoulder supervision with the audiologist making the clinical decisions and guiding the student. The billing would go out under the NPI of the supervising audiologist because, technically, he/she is the person who actually saw the patient. The documentation can have the student's name on the report, but that is optional. The critical name on the report will be the supervising audiologist under whose NPI the billing goes out. If you are not present in the office when the patient is seen, the billing and documentation must not be in your name. That would be considered fraudulent because you did not see the patient but billed for the service.
You will need to inform and coordinate with the student's home university that there will be other supervisors as part of the student's training experience.
Robert C. Fifer, Ph.D. is currently the Director of Audiology and Speech-Language Pathology at the Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine. He received his B.S. degree from the University of Nebraska at Omaha in Speech-Language Pathology with a minor in Deaf Education. His M.A. degree is from Central Michigan University in Audiology. And his Ph.D. degree is from Baylor College of Medicine in Audiology and Bioacoustics. Dr. Fifer's clinical and research interests focus on the areas of auditory evoked potentials, central auditory processing, early detection of hearing loss in children, and auditory anatomy and physiology. He is the immediate Past-President of the Florida Association of Speech-Language Pathologists and Audiologists, a member of ASHA's Health Care Economics Committee, and the ASHA representative to the American Medical Association's Health Care Professions Advisory Committee for the Relative Value Utilization Committee in addition to being ASHA's representative to the AMA's Practice Expense Advisory Committee. Additional responsibilities at the state level include serving as a consultant to the Florida Department of Health's Children's Medical Services and the audiology representative to the Genetics and Newborn Screening Advisory Council.
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