I would also like to add that I have spent hours agonizing over how to resolve this problem. We actually have a form that we send to all referring doctors offices. We have them check off on the form if they are requesting a transfer of care or a consultation, and we keep that paperwork in our chart, and we request that they do the same on a statement that is on the form. Many referring offices in our area have no clue about documentation requirements. They say of course we are sending the patient for a consultation. When we started to send out the form, doctors were calling me asking me what I was talking about. I am finding that many doctors have no idea about documentation requirements.
I have read that approximately 75 percent of consultations billed do not meet the requirements. You would think that Medicare would have the common sense to establish a policy that would save them millions/billions of dollars. If they would require a form be sent to all referring offices with the required information they would save money and clarify this "double-talk issue". We can't read minds! We can't second guess the intent of any doctor that is referring a patient to us. I can't say that I have ever read one article that has clarified this confusing issue. Most articles just add more confusion and create more uncertainty as to how to handle this issue.
In my mind, I would think that as long as the referring doctor wants an opinion and states it by using the word consultation or the word opinion in writing that it would be considered a consultation.
For some reason, it seems to be more accepted when patients are in a hospital setting. Multiple doctors call their visits a consultation, and yet they don't rescind their consultation status and consider it a transfer of care because the primary doctor or the original referring doctor can't treat the patient, so why does this seem to be where many of these articles are heading when they discuss office consultation patients and when the transfer of care takes place.
I would think that a consultation is a consultation (office or hospital).
Shouldn't the critieria be the request for the opinion/consult rather than whether the problem ends up being transferred to the consultant after the visit. If you send your written reply after the first visit then I would think that the transfer of care would have not yet taken place because you are giving your opinion regarding what you think the course of treatment should include. Even if you end up doing surgery or whatever, you have not performed it at that moment so I think that a transfer of care would not take place until after you have fulfilled the consultation requirements on that initial visit. This entire issue of when the transfer of care takes place and rescinding the consultation status is also very confusing. Much double-talk!!
I would appreciate any additional thoughts on this confusing issue.
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