Wiki consult vs established

[jhaley]

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?

 

[MCook]

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.

 

[mitchellde]

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!