OryxEezz44
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I am currently assisting a specialist practice in implementing Chronic Care Management (CCM). These are CPT codes 99490, and 99439
While they understand that as specialists, they can bill for these services, they have concerns regarding potential overlaps in care with local primary care providers who refer patients to them and might also be already providing and billing for the same service.
They’d like to avoid inadvertently overlapping with PCPs, which could lead to claim denials and strained professional relationships. Asking patients directly if they are receiving similar services from their PCP has proven to be only mildly reliable.
Has anyone here established a working protocol that specialists can follow to avoid billing conflicts and maintain positive relationships with referring PCPs? Highly appreciate any insights or experiences in managing these types of scenarios
While they understand that as specialists, they can bill for these services, they have concerns regarding potential overlaps in care with local primary care providers who refer patients to them and might also be already providing and billing for the same service.
They’d like to avoid inadvertently overlapping with PCPs, which could lead to claim denials and strained professional relationships. Asking patients directly if they are receiving similar services from their PCP has proven to be only mildly reliable.
Has anyone here established a working protocol that specialists can follow to avoid billing conflicts and maintain positive relationships with referring PCPs? Highly appreciate any insights or experiences in managing these types of scenarios