On 4/19/2014 6:57 PM, Debra Swank wrote:
> Would it help in advocating for a consult that is tailored in length to the needs of the dyad, and particularly tailored to the baby's motor learning needs when that's the reason for the consult, by reminding management that billing is also tailored to the length of the visit?  Is your outpatient facility currently  billing for your services?

Here is my another hat - practice management ;D

First of all, billing for a consult does require "3R" rule - Referral 
from the other provider, Rendering the service and Report. Level of 
consultation is decided by time, but minute by minute is definitely paid 
better then evaluation/management (E/M) visit
In all other situation you can bill for the E/M. That can be done by the 
degree of medical decision making or by time.

> I would also love to hear from other outpatient folks in regard to how reimbursement is working, now that we're this far into the Affordable Care Act.

Also, please get into the habit of differentiating PAYMENTS and 
REIMBURSEMENTS.

Reimbursement - is exact payment for somebody's expense (i.e. you 
attended the conference and your employer did - hopefully - reimbursed 
you for your expenses; or patient paid you your fee and her insurance 
company reimbursed her for some or all of this bill).

Payment - is something that the third party should pay YOU for YOUR 
services.  That can be the visit, or supplies that you sold to the 
patient (cost to you+cost of purchasing, storing, etc).

Alla

-- 
Alla Gordina, MD, IBCLC, FAAP
General Pediatrics
Breastfeeding Medicine
Adoption and Foster Care Medicine

Global Pediatrics and Family Medicine
NJ Breastfeeding Medicine Educational Initiative

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