This consult request form eliminates transfer-of-care concerns When a physician sends your ENT a patient for a specific problem, you can lock down the requester's intent with this form. Does the requester want your physician's opinion, or is he transferring the care of the patient's problem to your ENT? The answer can make the difference between a consult and an office visit -- and $33 based on coding 99203 for a level-three office visit instead of 99243 for a level-three consult (the 2008 Medicare Physician Fee Schedule assigns 2.55 transitional total relative value units to 99203 and 3.43 to 99243). Here's the standard form that Patricia A. Trites, MPA, CHBC, CPC, EMS, CHCC, CHCO, CHP, CEO of Healthcare Compliance Resources in Augusta, Mich., gives her clients: Dear Dr. ______________, It is our understanding that you have requested Dr. ________________ to perform a consultation on your patient, _______________________, for the following condition, symptoms or problem: ______________________________________. As you know, the definition of consultation has been changed by CMS, and we must now ask your intention regarding this patient. Would you like us to (Please Mark the Appropriate Box Below): Provide an opinion only regarding evaluation and/or management of this patient's condition Provide an opinion regarding the evaluation and/or management of this patient's condition as well as treat the patient for this condition We have appointed this patient on (date and time) ____________________________. Please fax this completed form back to our office at _______________ as soon as possible. In addition, please forward any necessary medical records to our office that you believe are pertinent for the evaluation of this patient's condition.