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EMTALA Issue?

By Esther Pitts posted 02-10-2015 07:43 PM

  
Hi All
      Background for my question :)
     When patients who have previously come in for stitches and return for suture removal they are registered, checked in (but not triaged), the nurse removes the sutures and sends the patient home.  There is no charge for this return visit.  BUT the patient is registered and is checked in under a new account. 
     The EMTALA question is since they are checking into the ED, they are not currently receiving a medical screening exam or seeing the physician.  The physicians are not charting on the encounter.  It is charged as a “no bill”.   Is this a potential violation?
     If the patient is not healing well, the physician does see the patient and the encounter is turned into a visit that is charged.  So if an auditor was to look at the visits it would appear that the patient is not receiving the medical screening exam as required by EMTALA when presenting to the Emergency Department. 

Thanks in advance for any and all input!!
Esther Pitts- Risk Coordinator
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https://exchange.ashrm.org/blogs/esther-pitts/2015/02/10/emtala-issue

Comments

Michael Sequeira
03-25-2015 08:48 AM

Hi Esther,
In all of our ED's the patient presenting for suture removal is seen by a provider, either PA or Doctor. The charge for the visit is included in the charge for the suture material. It is not a significant burden for the Provider to check the wound for any complication and then turn over the removal to the Nurse. This is the only safe way to avoid potential EMTALA violations of missing an emergent complication.