AAPC - Back to school
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  1. #1
    Join Date
    Apr 2007
    Nassau Central New York

    Default Billing consults vs new patients

    AAPC: Back to School
    I'm having a probem explaining to my office manager about the rules of billing a consult. I work in a Rheumtaology office and 8 months ago I told the office manager that we should not be billing consults unless we have a written request from the patients doctor. She told me I was wrong because we are a specialist and and the doctors are writing a consult letter to the referring doctor. I showed her 3 forms of proof that she was wrong. Well she finally found out that I was right when she went to a Medicare meeting and they showed her the rules of a consultant. Now what she has the front desk doing is faxing over consult requests to all new patients doctors that come in that don't have a written consult from their doctor. She is doing this for Medicare patients and the commerical insurances as well. I want to know is this legal? proper?. I am to hold all billing sheets that have consultation levels circled until they get this consult request from these patients doctors. I am the only ceritified coder in the office. Any answers on this practice?
    I feel if there is no written request for a consult we should be billing a new patient. I think she is just money hungry and I don't want to loose my certification because of her greed. Is there anything I can do? Any suggestions?
    Thank you
    Last edited by dede470; 12-30-2007 at 09:02 AM.

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