Consults without the Presence of the PatientPhysicians may occasionally be requested by a family member to consult with them without the patient being present during the service. Consults requested by physicians for parents or future parents should be billed to the parent's name and insurance carrier. The services may be documented based on counseling and/or coordination of care, with the topics discussed outlined in the report, including the total amount of time spent in consultation. Second or third opinions are reported with the use of the confirmatory consults. A confirmatory consult may be requested directly by a patient, family members, or referring physician. The referring physician's name and Unique Provider Identification Number (UPIN) should be included on the claim to facilitate billing. The servicing physician's name and UPIN may be included as the referring physician as well as the servicing physician if the name of the original referring physician is not known, or revealed at the time of the service. Confirmatory consults may also be documented based on counseling and/or coordination of care. Total time spent with the patient or family member, and an overview of the topics discussed must be included in the report. The service should be billed to the patient or the family member's health insurance carrier. Not all health insurance companies allow reimbursement of confirmatory consults. Completion of an Advanced Beneficiary Notice (ABN) may be useful to inform the person that they will be held responsible for incurred charges not reimbursed by the insurance company.
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