An established patient is defined as someone who

An established patient is defined as someone who

• A. One who has never seen the provider
• B. One who has received care from the provider or another provider in the same specialty within the same practice within the past 3 years
• C. One who has not received care in past 3 years
• D. One who has multiple visits on same day

Answer: (B)

The main idea here is how clinicians classify patients for billing and records: established versus new. An established patient is someone who has received professional services from the physician or another clinician in the same practice within the past three years. This three-year look-back means the practice already knows the patient’s history and care patterns, which affects billing levels and documentation. So the best match is someone who has had care from the provider or another clinician in the same practice within the past three years. If there’s been no care in that period, the patient would be considered new for coding purposes. The other options don’t fit because they either describe people who have never been seen (new patient), those with no care in over three years (also new), or a scenario of multiple visits in a single day (not relevant to establishing status).

The main idea here is how clinicians classify patients for billing and records: established versus new. An established patient is someone who has received professional services from the physician or another clinician in the same practice within the past three years. This three-year look-back means the practice already knows the patient’s history and care patterns, which affects billing levels and documentation.

So the best match is someone who has had care from the provider or another clinician in the same practice within the past three years. If there’s been no care in that period, the patient would be considered new for coding purposes. The other options don’t fit because they either describe people who have never been seen (new patient), those with no care in over three years (also new), or a scenario of multiple visits in a single day (not relevant to establishing status).