This form will save you time, effort and denials Documentation--or lack thereof--can determine whether you-ll see reimbursement for consultations that your neurosurgeon provides. When another physician refers a patient to your office for a consultation, use the following document, provided by Patricia Trites, MPA, CHBC, CPC, CHCC, CHCO, CEO of Healthcare Compliance Resources in Augusta, Mich. You could either fax or mail the form, which provides a clearly documented request and reason for the consultation. From the Healthcare Organization and Medical Office Compliance Program Guide Copyright - Date Dear Dr. ______________, It is our understanding that you have requested Dr. ________________ We have appointed this patient on (date and time) _________________________________. Please forward any necessary medical records to our office that you believe are pertinent for the evaluation of this patient's condition. If our information is incorrect, please notify us as soon as possible so that we may make the necessary changes. Dr. _________________________ will forward you his/her opinion regarding this patient as soon as possible following the appointment.
1999-2006. Used With Permission from Healthcare Compliance Resources LLC.
to perform a consultation on your patient, _______________________,
for the following condition, symptoms or problem: ______________________________________.
Thank you,