Practice Management Q&As

March 2, 2007

Monitoring phone calls and e-mail

Our group's new policy manual states that management reserves the right to monitor doctors' and staff members' phone calls and review our e-mail without our knowledge. It seems to me this policy could breach patient confidentiality. Is this legal?

Yes, as long as there's a business reason for such monitoring, it's legal for an employer to listen in on business phone conversations and review e-mail. The HIPAA Privacy Rule permits a covered entity to use and disclose protected health information for healthcare operations purposes. That would seem to include listening in on conversations with patients for quality assessment and improvement. A recorded message should advise all parties that the call might be monitored.

A code for medical testimony?

Does CPT code 99075 limit what I can bill for giving a deposition?

No, you can charge whatever you like. 99075 [Medical testimony] is used for billing lawyers and others for whom you provide medically-related depositions or testimony. It has a status indicator of "N" for noncovered in the Medicare Physician Fee Schedule and there are no RVUs assigned to it. However, when you testify before certain bodies, like a workers' compensation board for example, you'll be paid according to their reimbursement schedule.

Can an NP make this referral?

I'm employed by an urgent care center as a collaborating physician for nurse practitioners. I also have my own private practice where I offer osteopathic manipulation and acupuncture. If one of the NPs refers a patient to me for acupuncture at my private practice, are we breaking any laws?

Probably not. Under federal law there's no problem as long as the NPs aren't paid by you and have no financial relationship with you that rewards them for referring patients. It's possible that your state's anti-referral laws may bar such a practice-and you should check-but it's likely that since you are all just co-workers employed by the same clinic, the nurses can refer to you at your private practice.

In this issue, the answers to our readers' questions were provided by: Jack Rue Coleman, CHBC, Dental-Medical Economics, Dallas, TX; Barbara Fick, Assoc. Professor, Notre Dame Law School, Notre Dame, IN; Alice G. Gosfield, JD, Alice G. Gosfield and Associates, Philadelphia, PA; Betsy Nicoletti, Medical Practice Consulting, Springfield, VT.

Do you have a practice management question that may be stumping other doctors, too? Write PMQA Editor, Medical Economics, 123 Tice Blvd., Suite 300, Woodcliff Lake, NJ 07677-7664, or send an e-mail to mepractice@advanstar.com (please include your regular postal address). Sorry, but we're not able to answer readers individually.