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Gastroenterology Coding Alert

Reader Question:

Avoid Medicare Denials For Hospice Care

Published on Sun May 13, 2012

Question: We recently received a denial from Medicare for a patient in hospice care. Can we bill the hospice for the services provided by our gastroenterologist or should we try the insurance payer to pay for the services rendered?Michigan SubscriberAnswer: The hospice is not liable to pay for the services rendered by your gastroenterologist to the patient. The hospice could have been billed for the services rendered by your gastroenterologist if there was a prior arrangement between the hospice and your gastroenterologist for the services rendered to the patient. Your gastroenterologist would have been eligible for payment from the hospice if he was a consulting gastroenterologist for the hospice or was employed by the hospice to render the services in question to the patient.However since there is no such prior arrangements between the hospice provider and your gastroenterologist, it is best to again try to re-bill the insurance payer. You [...]
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