Wiki Echocardiogram question

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JENNIFERNMA

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Hi, i am wondering if anyone can help. We are a multispecialty practice. My boss wants to hire a tech to do echos in our office and have a cardiologist at our affiliated hospital read them. I am new at cardiology so i'm not sure how to bill this? They are saying its ok to bill as long as they are credentialed at our practice even if they never see or touch the patient here. Anyone have any ideas?
 
I would make sure you have a cardiologist on board w/this 1st. I have a cardiology group & we tried to do that w/some PCP offices that wanted to 'expand' their roles - here's the problem...the company they used got paid their -TC but we had a horrible time recouping the least bit of revenue from the arduous hours my docs spent reading them...in many cases, they needed to bring the pts back for a more "definitive" view but the biggest issue then [and it's worse now} w/echos is all the precertification that must be done for most major carriers {AETNA, CIGNA, UHC, Coventry} which requires notes and extensive documentation to support the medical necessity - even for just a 93306. Even for the carriers that don't require precert, they wanted medical necessity documentation -so there was constant contact w/the PCP office just to get notes [and notes that didn't contain enough support 'in my eyes']. Simple 401.9 & PCP wanted an echo...My docs won't do that again.
 
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