What defines a new patient?

A new patient is defined as someone who has not received any professional services from the physician or another physician of the same specialty in the same group practice within the last three years. This definition is crucial for proper billing practices, as it determines how services are categorized, billed, and may impact reimbursement rates.

In the scenario provided, identifying an individual as a new patient allows a healthcare provider to bill for an initial visit, which often incurs a different rate than follow-up visits. Understanding this classification is essential for accurate coding and billing processes within a physician's office.

The other options incorrectly suggest shorter timeframes for classifying a patient as "new," which could lead to errors in billing and reimbursement. Proper adherence to the three-year guideline is established in coding manuals and ensures that healthcare providers are compliant with insurance billing standards.