This page discusses our policies regarding fee-based personal telephone communication with your physician.
These services are offered only to established patients who are residents of Colorado or New Mexico, and who may access the service only while in one of those states.
No Fee Telephone Services
There is no charge for routine calls to our scheduling or billing staff, or to our nurses, physican assistants or nurse practitioner. In many cases your physician may initiate a personal telephone call to follow up an active matter, for which there is also no charge. The fee based communication option described below is offered as a more convenient and cost effective optional alternative to a traditional office visit for selected patients.
In many cases, telephone consultation with your physician gastroenterologist may provide an effective and convenient alternative to a traditional clinic visit. Telephone consultations can be used to for you to provide your physician gastroenterologist with new medical history and discuss consideration of new endoscopy, radiology or laboratory evaluations. Consultations can allow us to consider adjustments in your treatment or diagnostic plans, including the addition of new medications or the need for additional diagnostic or treatment plans.
Because telephone consultations can be conducted outside of your physician's usual clinic hours, scheduling is limited only by your availability and the personal availability of your doctor. For this reason, telephone consultations can generally be provided more quickly than an office appointment.
Fee-based Telephone Services
Telephone communication of this type is an optional fee-based service which may or may not be reimbursed by your private health plan. You may ask your insurer if it covers the codes identified below prior to initiating fee-based telephone services. Medicare has designated this service to be "noncovered," which means that it is not a benefit of the Medicare program (similar to many preventive services). Medicare beneficiaries have the right to privately purchase noncovered services.
Fee-based telephone services are rendered only at the patient's request. Fees for this service are necessary because of the costs we incur in providing it. A review of your medical record at Digestive Health, the Southwest Endoscopy Center and Mercy Medical Center is necessary as a part of this service, and documentation of our communication must be prepared and maintained in your Digestive Health record.
We will, as medically appropriate, issue physician's orders for additional laboratory, imaging (radiology) or endoscopy services on the basis of these communications. We may also issue new or renewed prescriptions.
In some cases, we may need to have you come to the office for a traditional visit and physical examination (in which case there will be no fee for the telephone communication).
Despite the necessity for fees to cover this service, in many cases, this form of communication service may be more expeditious and cost effective for you than a formal clinic visit.
Our 2013 fees for these services are time-based:
CPT® 99441 (5-10 minutes of medical discussion and physician documentation) $69
CPT® 99442 (11-20 minutes of medical discussion and physician documentation) $108
CPT® 99443 (21-30 minutes of medical discussion and physician documentation) $145
What to ask your insurer regarding coverage for this service
Ask your insurer if your policy provides coverage for services designated by CPT® codes 99441-99443.
We are happy to provide you with this service on a private self pay basis if it is not a covered benefit of your policy and if we are not precluded by our agreement with your health plan from providing it to you.