Non-Office bills include communication by phone, email, or text messages. The physician should use prudent judgment guided by relevant state medical board policies and professional guidelines to determine which patient concerns can be reasonably managed without an office visit.
General Principles
A SENTIRE non-office visits that is initiated by a patient is billed as a flat initial fee plus a fee for the amount of time spent in communication with the patient. This should not include documentation time. The actual bill should be created using the SENTIRE website or phone/device app.
Phone Visits
Phone visits should be billed for the actual time conversing on the phone, not documentation time. Total time should be billed even if it occurs over more than one phone call to fully address a patient concern. A reasonable exception to the time rule could include time spent reviewing old records, lab and x-ray results not ordered by the SENTIRE physician, and other similar uses of time spent on the patient’s behalf.
E-mail and Text Message Visits
Email visits should be billed for the actual time reading and writing email and text messages, not documentation time or time waiting for the next message to be transmitted. It is assumed that the time from the first message to the last, to address patient concern(s), will often occur while the physician is caring for other patients. The physician is expected to make a good faith effort to only bill for the time required to read and write the messages.
Other Issues
Almost all non-office visit charges should be the result of patient-initiated concerns. Calling a patient with lab results or confirming a chronic prescription was refilled are units of work that should have been already billed with Information Management fees. However, it is recognized that there may be unusual situations where a physician must communicate with the patient that did not arise from a typical office visit or previous non-office communication. The physician may bill the patient, but not include the initial flat fee.