READER QUESTIONS:
Identify the Request Before Billing a Consult
Published on Thu Feb 19, 2009
Question: If our doctor does surgery on a patient who is an inpatient, shouldn't we be charging for a consult? Georgia Subscriber Answer: You should only bill for a consultation if the primary physician requested a consultation from your physician. In other words, only bill a consultation if the primary doc requested your doctor's opinion or advice for a treatment plan for a specific condition. If your physician was called in just to perform a surgery, and there was no request for an opinion or recommendation, then you cannot bill a consult. But keep in mind that a consultant can lead to treatment once the physician completes his consultation. When you submit a consult claim, you should also include documentation that explains the consultation circumstances. Documentation requirements for consults vary by payer, but experts say your consult documentation should at least include evidence of: - a written or documented request [...]