After evaluating our options, we decided to not enter the superbill directly and go with something similar to what Brian suggests above. The only twist is that we create patient encounter for each day that the patient is in the hospital. Entering them separately makes the billing submission and traceability much easier (makes the CMS1500s and invoices appear correctly).
The physician collects the face sheet at the hospital for billing purposes. She will also secure the discharge summary once it is available.
These paper copies are then provided to the medical assistant. Under "Chief Complaint", the medical assistant enters "HOSPTALIZATION, mm/dd/yyyy"
We created a template under assessment that states "Patient was seen at West Shore Medical Center. Hospital maintains medical record and this encounter exists for billing purposes."
The medical assistant then forwards the chart to the physician for entry of ICD9 codes and creation of the invoice. She changes "CHART" to "HOSPITAL" in the subject line to better differentiate the messages. Once the first encounter is signed, subsequent encounters can then be created by the physician from the initial or "prior encounter". This brings along the ICD9 codes and makes following days very easy to invoice.
