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To: ebersole

But won’t they require a “code” or something from the primary physician? Even if not, the patient would probably still have to have insurance to get the procedure done, unless they want to just get a big bill.


28 posted on 03/24/2010 6:24:39 PM PDT by MrChips (MrChips)
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To: MrChips

No...the billing codes and (diagnosis codes) are different. When the facility and the other physicians bill the insurances, they (or their staff) make their own diagnosis and for that diagnosis there is a correlating billing code that is sent to the insurance companies or the government. Nothing, in terms of money or payment, goes back to the primary (or referring) physician. The tricky part for these patients may be if their insurance company requires a referral from their primary care doctor to see a specialist. Most of my experience shows that as long as the primary care physician writes a “prescription”, that the referral is acknowledged and accepted. Maybe someone here with more experience could add something more:)


35 posted on 03/24/2010 6:51:18 PM PDT by ebersole
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