New Vein Center Opening Up - Need help

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Our cardiothoracic/vascular surgeon has opened up a new vein center in his office. We have been told we need to set up an Independent Treatment Facility so they would need a separtate MC and Medicaid #. The tech is performing the ultrasounds after patients referred to the vein center. Then the cardioivascular doctor is seeing the patient in consultation after the test is performed. We are not sure if we need this Independent tretament facility set up. We just need some guidelines regarding this center. Right now the tech is performing the ultrasounds and the doctor is doing the consult at a later date. Can we actually bill a consult since the patient was already seen in the clinic for the U/S and we only charge for the U/S and then a consult at a later date?

The reason the Tech says we need the IDTF is that then the doctor can charge the interpretation of the U/S and get (probably an additoinal $10.00) charge.

We do not see the necessity of setting this center up with all the extra work involved with credentialing for insurance companies, getting new Medicare and Medicaid numbers for the facility.

What we are looking for is some feedback to our questions and if there is anyone out there who has one of these centers in a physician's office. I would think it would be just the physician's office, see the patient in consultation, order the U/S and just charge for the consult and the U/S and forget about the interpretation charges as he does own the equipment, there by eliminating the need for new MC and M'caid #s and credentialing for the facility for all managed care plans.

Please help us with any suggestions you might have.

Thank you,
 

Davistm

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I work for a multi-specialty cardiology group that has a "vein clinic" operated by our vascular surgeons. It is not an IDTF. We bill globally [we own the diagnostic testing equipment] using our group NPI. No problems with Medicare or commercial payers.

I can provide more information but it would lengthy. If you want, you may call at 405 608 1207 or send a private response and I can take some time to respond.

I agree with you, you don't need to be an IDTF and in fact, probably do not meet the requirements to be classified as such. Your carrier should have "rules" on becoming an IDTF and your state may also have regulations that apply.

Terry
 

bmorin

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I also agree. You can bill the consult at a later date once the testing is done. I work for a group of vascular surgeons and this is how we see our patients. We do the testing and then the consult is test so that the md knows exactly what the problem the patient may or may not have, also we treat our patients this way b/c the testing itself is lengthy for the patient and then to wait for the doctor to be seen. We used to do both on the same day but the patients complained that it was too long for them to be there so now we split it.
 
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