My Other Doctor Wants Me to Have a Test

QuestionsThis office is prepared to draw blood and send off laboratory tests that your specialty physicians request. Most of the specialty physicians no longer have staff that draws blood nor do they have in office drawing stations or labs. In order to draw a lab on a patient requested by another physician I need to know exactly what test they are requesting in advance of your visit. I need to know what diagnosis your specialty physician is using to justify this test. If you are a Medicare patient this requirement is the law. Failure to follow it results in fines and penalties for my practice. If you are not a Medicare patient and have private insurance we need to know which lab your insurer is contracted with in addition to having some written documentation of the test requested and the diagnosis for the test. Unless we have this data your insurer will not pay for the test. The documentation can be in the form of a prescription with your name on it plus the test and the diagnosis. The documentation can be part of a consultation note written by your specialty physician and mailed or faxed to our office.

The same rules apply to x-ray or Imaging Studies. I need to know what test is being ordered in writing and what the diagnosis to justify ordering it. It is not sufficient to request a CT scan or an MRI. I need to know what type of CT scan or MRI and specifically what body part(s) we should be imaging. Should intravenous and or oral contrast be used? Is there a preferred imaging center the insurance company is contracted with and do you need pre authorization. Once again if this process is not followed the insurance company will not pay for the test. Keep in mind a CT scan with and without contrast of the chest, abdomen or pelvis are 2 distinct tests each exposing you to the equivalent of 10 years’ worth of x-ray irradiation.

Our office staff strives to provide you with excellent service. There are some basic rules we do have to follow according to the law. Please cooperate when we ask for your help with this issue. Thank you.

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