• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki consult vs established

jhaley

New
Messages
1
Location
Perris, CA
Best answers
0
If a provider belongs to two separate specialites ( Hepatology and Transplant) can he issues a self referral for the patient to see him as a consult visit under his other speciality? Or does he have to bill that consult visit as an established?
 
I would say the patient would be established. I can't quote a source for you to reference though. I don't think an insurance carrier would accept a doctor referring to himself. I think your best bet would be to call the carrier direct to see if this would be permissible.
 
It is not permissable to self refer for a consult. This is way too close to several violations for comfort. Think of it as self serving, or as one told me once the self licking ice cream cone!
 
Top