Documentation and Billing > Documentation and Billing

4. Group Visit Workflow

Now that you are prepared, what is the overall flow of the group visit? This section will describe workflows you may want to utilize for the ENACT group visits:

Arrival, check-in, and medical update

  • A dedicated MA’s participation is essential to the successful flow of ENACT Group Visits
  • Use Check-In Sheet (Appendix D of Manual)
  • Vitals
  • Review of Systems and other clinical questions
  • Medication lists can be handed to patients for review

(Can we give some examples here – or a short video showing this process?)

Once check-in is completed, transition to discussion, goal setting, and check-out – which will all be covered in detail in Modules 3 and 4.

5. Documentation and Billing for Group Visits

There is no special coding mechanism for group visits. Individual documentation and billing is submitted for each patient according to regular Evaluation and Management service guidelines. Coding should be based on what is completed during the group visit and the possible additional individual patient interaction. Coding cannot be based on time.

Medical visit components:

  • Vitals are taken by the medical assistant and reviewed by the provider at check-in
  • Medication lists can be handed to patients for review, and any updates documented by MA
  • A Check In form can be used to ask about Review of Systems and other clinical questions typically asked by the MAs at the time of check in. The forms can be collected, documented by MAs, and returned to the provider for review.
  • The Check In form can ask “Do you have any medical concerns you wish to discuss at this visit?” and “Would you like to see the physician for an individual visit after today’s group session?”

A sample check-in template has been provided to assist with collecting medical updates and determining which patients desire or need an individual visit.

Documentation tips:

  • Create .doc phrases to assist with documentation
  • Take notes of individual patients’ contributions/statements during the group visit for the HPI.
  • In general, if a participant is NOT seen individually, a provider can only bill a level I-III (typically level III if multiple medical conditions are reviewed/addressed during the group portion).
  • If a participant is seen individually, depending on what portions of the physical exam are completed and what interventions are made, a provider can bill higher (typically level IV).