Wiki Charging an E&M when referring to ER

[karlam]

We are a primary care/urgent care facility withouth hospital priviledges. Is it appropriate to bill an E&M when we did an examination and made the determination to refer to the ER for treatment? I was taught "no treatment means no charges for E&M". Help!! I don't want to throw money away nor do I want to bill inappropriately!!!

 

[AuntJoyce]

I recently took my niece to an urgent care facility (also with no hospital privileges). They determined that she needed to go to an actual emergency room. I questioned whether it was appropriate to have paid a co-pay and it was explained to me that as long as they took a history, performed an examination, did some blood work and formulated a diagnosis, they were going to submit their billing for an E&M. Consequently, my niece received an EOB containing the charges for both the urgent care center AND the emergency room in which both were reimbursed accordingly.

Hey, if your docs do the work-up and formulate a diagnosis and feel that the patient would best be served in a hospital (E.R.) setting, you should not have to eat the service rendered.

Hope this helps!