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Wiki Medicare Advantage plans needing Referral from PCP

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ENTcoderConnecticut

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Bridgeport, CT
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We are seeing MA's requiring that PCP referrals to specialist state a code for: Procedure as well as for E/M.

Has any other practice noticed this?
 
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I work in Radiology, Yes we are seeing Referrals are needed from PCP. The PCP sent them to Specialist and the Specialist is referring them for Radiology exam, we have to call the PCP to do a "Referral" (which is not the authorization... thats a whole other ball game.)


Hope this helps.


JB
North Carolina
 
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