Specialist Advice for Patient Management - Initiated by a Specialist, General Practitioner, Allied Health Provider or coordinators of the patient’s care. Response in one week – per 15 minutes or portion thereof. The purpose of this fee is for the specialist to provide real-time advice when the intent of communication is to replace the need for the specialist to see the patient in person. The consulting specialist is responsible for ensuring that an appropriate communication modality is used to meet the medical needs of the patient.
i) Payable to Specialist Physicians for telephone, video technology or face to face communication regarding assessment and management of a patient but without the consulting physician seeing the patient.
ii) Conversation must take place within 7 days of the initiating
iii) Includes discussion of pertinent family/patient history, history of
presenting complaint, and discussion of the patient's condition and management after reviewing laboratory and other data where indicated.
iv) A chart entry, including time of initiating request as well as advice given and to whom, is required.
v) Include start and end times in the patient’s chart and time fields when submitting claim.
vi) Limited to two services per patient per physician per week. vii) Not payable to physician initiating communication.
viii) Not payable in addition to another service on the same day, for the same patient by same practitioner.
ix) The specialist is responsible for the confidentiality and security of all records and transmissions related to video technology.