Part B Insider (Multispecialty) Coding Alert
Consult Request Form
It's time to streamline your consult request form. Here's the standard form that consultant Patricia Trites with Compliance Resources in Augusta, MI, 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 the 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.
Part B Insider (Multispecialty) Coding Alert
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Consult Request Form
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