Hospital Physicians Interpreting Medicare studies

Moderators: TexasSleepguy, SCNVsleep, labman2

Hospital Physicians Interpreting Medicare studies

Postby Awake » Tue Oct 27, 2015 9:30 pm

Are non boarded hospital physicians allowed to interpret medicare studies? As far as I know techs don't have to be credentialed to run a medicare study in a hospital. I wonder if the same is true for physicians.
Awake
Member
 
Posts: 5
Joined: Tue Apr 14, 2015 8:10 pm

Re: Hospital Physicians Interpreting Medicare studies

Postby SCNVsleep » Wed Oct 28, 2015 12:11 am

Techs need to be credentialed and physicians need to be boarded in sleep regardless of service location.
User avatar
SCNVsleep
Moderator
 
Posts: 2312
Joined: Fri Mar 21, 2003 11:26 pm
Location: Houston, TX

Re: Hospital Physicians Interpreting Medicare studies

Postby respbarb » Sat Oct 31, 2015 3:26 am

When you say " in the hospital" do you mean as an inpatient?
If the patient receiving the study is an inpatient, is Medicare getting billed for the study? Doesn't the DRG's prevent the hospital from billing for the study?
That is why we don't run sleep studies on inpatients.
User avatar
respbarb
Moderator
 
Posts: 1418
Joined: Thu Mar 20, 2003 5:05 pm
Location: Martinsville, VA

Re: Hospital Physicians Interpreting Medicare studies

Postby somnonaut » Sun Nov 01, 2015 3:25 pm

I was told there is the possbility of billing for in-patients if the opportunity to bill as an "Out-lier" has not been used up yet. As was told to me by VP of Admitting back when I was in hospital setting, every DRG has ability to bill for things not specific for that DRG (out-lier), but this usually gets eaten up quickly within an admission.

https://www.cms.gov/Medicare/Medicare-F ... tlier.html
User avatar
somnonaut
Senior Member
 
Posts: 14154
Joined: Thu Dec 11, 2003 6:03 pm
Location: http://tinyurl.com/righteousdude

Re: Hospital Physicians Interpreting Medicare studies

Postby rottiemama2003 » Wed Nov 04, 2015 5:00 am

I our region the techs must be credentialed and Dr as well or Medicare / Medicaid will not pay effective Oct 1, 2015
User avatar
rottiemama2003
Member
 
Posts: 292
Joined: Sat Jul 14, 2007 5:33 am
Location: Southern IL

Re: Hospital Physicians Interpreting Medicare studies

Postby Awake » Wed Nov 04, 2015 7:10 pm

I found this FAQ. I got my answer.

"Our company is having a disagreement with a local physician's group regarding whether or not some of the physicians in the practice qualify under Medicare guidelines to interpret sleep tests. While these physicians are not "board certified" they are active staff members of a sleep lab associated with a Joint Commission accredited hospital. The physicians insist, therefore, that they not only meet Medicare guidelines to interpret sleep tests at this facility but also at their own privately owned, non-accredited sleep lab. We do not feel that this is the case. We have informed them that we can accept qualifying sleep tests from the accredited hospital lab but not from their privately owned lab. Are we correct?"
· You are correct. Physicians who do not have individual board certification are operating under the umbrella of a facility's accreditation. Therefore these physicians would only qualify to interpret sleep tests when the service is performed within the facility that is "certifying" their competence by granting them sleep lab staff privileges


https://www.cgsmedicare.com/jc/help/faq ... in11.html#
Awake
Member
 
Posts: 5
Joined: Tue Apr 14, 2015 8:10 pm


Return to Managing a Sleep Lab

Who is online

Users browsing this forum: No registered users and 1 guest

cron