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consult vs established

J

jhaley

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Perris, CA
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!
 
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