Radiology group for the hospital - question

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A radiology group is contracted with a local hospital.



The hospital bills the technical component.



The rad group bills the professional component.



According to the rad group administrator, they cannot produce the procedure
interpretation report, it 'belongs' to the hospital and the patient has to
go through medical records at the hospital.



Comments?



Karen A. Hurley, BS, CMM, CPC, CNA

President, HPMSI

PO Box 409

Parrish, FL 34219

Tel: (941) 776-4822

Fax: (240) 368-0059

Web: www.hpmsi.com



Since 1996, Celebrating 20 years of Service to Physicians



Disclaimer: Advice or comments given in this email are specific only to the
recipient and the presented issue. It is not intended to be used as a
global solution for future similar events. Reproduction of the information
requires approval by the author.






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A radiology group is contracted with a local =
hospital.

 

The hospital bills =
the technical component.

 

The rad group bills =
the professional component.

 

According to the rad =
group administrator, they cannot produce the procedure interpretation =
report, it ‘belongs’ to the hospital and the patient has to =
go through medical records at the hospital.

 

Comments?

 

Karen A. Hurley, BS, CMM, CPC, =
CNA

President, =
HPMSI

PO Box 409

Parrish, FL 34219

Tel: (941) 776-4822

Fax: (240) 368-0059

Web: www.hpmsi.com

 

Since 1996, Celebrating 20 =
years of Service to Physicians

 

Disclaimer:  Advice or comments given in this email are =
specific only to the recipient and the presented issue.  It is not =
intended to be used as a global solution for future similar =
events.  Reproduction of the information requires approval by the =
author.

 

 

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Comments

  • I would have to ask is the radiologist using a dictating system owned and operated by the hospital? The rad should have a copy of the report, at least for billing purposes, but in fact, the hospital is responsible for the records.


    Just a thought.


    Linda Bryant



  • Actually, if you, as the interpreting/professional billing provider, request copies of the reports for treatment, payment, or operations, the hospital must supply them.

    Kris

    Kris Cuddy, CPC, CIMC
    Healthcare Compliance Analyst
    Compliance Office
    Michigan State University HealthTeam
    East Lansing, MI
    Ofc: 517-355-4547
    Fax: 517-353-5292
    Sent from my iPhone

  • Making sure I am understanding the question but may not have an answer, this is the PATIENT requesting a copy of the report correct not the interpreting provider thus it isn't for treatment, payment or operations?

    Ruby Woodward
    Sent from my iPhone

  • Good point.

    The patient is allowed to have copies too. It doesn't matter who interpreted for radiology, it's the place where the service was rendered where the patient will get copies of their reports and/or films.

    Have you ever had an X-ray/CT/MRI at a hospital or other diagnostic facility? When you need the report or films for a specialist, you have to reach out to the place you had the imaging/diagnostic study to get copies of films/reports.

    Hope that helps to clarify.

    Kris

    Kris Cuddy, CPC, CIMC
    Healthcare Compliance Analyst
    Compliance Office
    Michigan State University HealthTeam
    East Lansing, MI
    Ofc: 517-355-4547
    Fax: 517-353-5292
    Sent from my iPhone

  • edited May 2017
    If the billing for the interp is done under a separate tax ID from the facility – and you are paying the entity that provided the interp (in full, deductible, and/or coinsurance)………..you should be able to get a copy of what you paid for through the entity that was paid for it.



    I agree, the facility that has the hardware needs the report on record to justify the use of the equipment, however the entity paid to generate the report should be able to produce it to the patient at their request.



    Block 31 of the claim form is the provider’s signature which states they have followed what is written on the back of the form. Directly under the bolded words Medicaid Payments (Provider Certification) is the statement that the provider agrees to keep records of what they are billing for. (At the top of the form it does indicate that for other than government plans, see separate instructions.)



    I am still on the side that the billing entity should be able to produce the record.



    Karen A. Hurley, BS, CMM, CPC, CNA

    President, HPMSI

    PO Box 409

    Parrish, FL 34219-0409

    Tel: (941) 776-4822

    Fax: (240) 368-0059

    Web: www.hpmsi.com



    Since 1996, Celebrating 20 years of Service to Physicians



  • edited May 2017
    I agree with you Karen. If a radiologist is going to bill me for a medical
    service (interpretation), he better be prepared to provide me with a copy
    of what he did. Doesn't matter where the service was provided.
    Same thing happens with ED doctors, they try to tell you that the hospital
    has the records and you have to get the doctor's record from the hospital.
    I've filed a complaint with OCR against an ED group who refuses to provide
    me a record showing that the doctor that billed me did anything. Maybe the
    OCR will rule against me, but until then I will continue to argue the
    point.


  • Karen,


    Guess this whole question took a left turn somewhere. The hospital needs to give the patient the report, not the radiologist. The hospital would also supply any films, disc or reproduction of images required by the patient. The hospital owns the studies done and are responsible for storage of those studies as per state law regulations. It is not the job of the radiologist or his staff to maintain anything other than what is required to bill....BUT, we read for a hospital, we utilize our dictation equipment and our transcriptionist checks, corrects (grammatical corrections) all reports and releases them to the hospital once the doctor signs. We do not send the reports to the referring physician, that is the responsibility of the hospital. We do send reports immediately to the ER when requested. We do store copies of those reports for billing reasons and peer review. We refer patients who ask for copies of their reports to the medical records department of the hospital.


    Hope this clarifies.


    Linda Bryant



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