Part B Insider (Multispecialty) Coding Alert

Cash-only business provides profitable sideline for specialists

If your physicians are experts in a particular area - or combine a lot of different types of expertise, such as in a multi-specialty clinic - then you might consider marketing that unique expertise more widely.

Many practices and clinics are starting to market "second-opinion services," in which patients or referral sources can seek another point of view on a problem. They'll usually promise a speedy turnaround and helpful feedback. Often, these programs will offer both face-to-face and "virtual" consultations.

Such programs can prove to be a winner, because you often can bill patients directly for many aspects of them, say experts. "It's basically a cash-only business, which is what makes it appealing" to many physicians, says Elizabeth Woodcock, director of knowledge management with Physicians Practice in Glen Burnie, MD.

For example, Tiburon, CA pathologist Michael Lagios specializes in breast cancer and is an expert on one particular type, duct carcinoma in situ. Lagios markets his second-opinion service to patients over the Internet and by word-of-mouth, and also receives physician referrals. He generally sees patients who want to confirm a controversial diagnosis or the need for a particular treatment option.

"In my practice there are significant differences in interpretation in about 10 percent of cases," says Lagios. These include the stage of carcinoma and the malignancy of the tumor. He sees patients in person, but also reviews mammograms, ultrasounds and MRIs for patients all over the country.

The University of Kansas Hospital in Kansas City started its cardiac second opinion service in January, and markets it to patients and referring physicians via the Internet as well as in newsletters and brochures. "We've always done second opinions," notes Julie Amor, marketing director. "We just haven't really marketed that service as much as we have since January."

"It's common for people to  seek a second opinion sometimes  for cancer diagnoses, but thinking about a second opinion for cardiac diagnoses may be a new way of thinking for people," adds Amor. In the past six months, the Kansas second-opinion program has seen approximately ten patients.