What defines an established patient in a medical context?

An established patient in a medical context is defined as someone who has received services from a physician or a healthcare provider within a specific timeframe, typically within the past three years. This designation is important for billing and coding purposes, influencing how medical practices manage patient records and insurance claims.

When a patient is considered established, it indicates a prior relationship with the provider, which can streamline administrative processes and often allows for a more efficient examination since the provider may already be familiar with the patient's medical history and needs.

In contrast, a patient who has not visited the physician's office at all would be classified as a new patient, while the timeframe of six months mentioned would not meet the broader industry standard of three years for establishing ongoing patient-provider relationships. Additionally, the status related to seeing a different specialist does not inherently affect whether a patient is categorized as established or not; it's the continuity of care with the same provider that primarily dictates this status.