Re: Sterilization

From: Joanne Bulley, MD (islesannie@yahoo.com)
Wed Mar 9 22:51:04 2005

In NH there is even a special form for hyst ... if she has had a previous tubal then there is another form I (the surgeon) has to fill out that she was already sterile before the hyst and so it waives the need for the form #XYZ that would otherwise be required (with the waiting period) or a declaration that it was a true emergency.

I had someone that they faxed me the form to say she was already sterile. Since you could barely read the fax and we knew it would get worse with a re-fax back -- we re-typed it with the exact same format / spacing / etc -- and they said it was no good because it wasn't "their" form.

We told them to compare them word for word for word and punctuation for (etc) and they finally accepted it and paid me the few bucks I got for it.

Joanne

At Wed, 9 Mar 2005, Dr. Ainsworth wrote: >
>>1. We have been told at my facility that if a tubal is carried out at the
>>time of cesarean section and the government form has not been signed, the
>>entire hospital stay is denied, both physician and hospital reimbursement.
>>Is this true or false? Previously, it was my understanding that they
>>wouldn't pay for the tubal portion of the procedure and was perfectly fine
>>with giving up the $80 they pay for a tubal at the time of cesarean.
>
>This is the rule for California and they are required by federal law,
>each state will have a similar rule:
>
>Sections 51305.1 through 51305.6 of Title 22 of the California Code of
>Regulations requires the submission of a properly completed copy of
>the appropriate consent form before providers can be paid for
>sterilization services. This is not a new policy and has been previously
>communicated to providers through the Provider Manual.
>For tubals and vasectomies, only a PM-330 consent form is acceptable.
>For hysterectomies, any form of written consent is allowable, as long as
>the member indicates via signature that she understands that the
>procedure will leave her unable to bear children. It is important to
>note
>that Medi-Cal members cannot waive the 30-day waiting period
>requirement except in the emergencies as noted in the regulations.
>Failure to comply with this waiting period will result in denial of
>payment to all parties involved in the procedure.
>The Alliance requires the primary surgeon to submit the consent. If
>the consent is not submitted along with his or her claim, it will be
>denied, but will be payable if the claim is resubmitted with the
>consent.
>Other providers involved in the case do not need to submit a copy of
>the consent. In cases where the primary surgeon does not submit the
>consent, we will hold other providers’ claims until it arrives. If,
>after
>30 days, the consent has not been submitted, the other providers will be
>notified of a payment delay due to the lack of a consent form.

--
Joanne Bulley, MD
Keene, NH, USA



use when must restrict search to only the ob-gyn-l forum...
Enter search keywords:
Returns per screen: Require all keywords:

Return to OB-GYN-L Mail a New Message to the Forum: ob-gyn-l@obgyn.net
Forum Administrator: geffrey.klein@obgyn.net
Report Technical Problems: webmaster@obgyn.net
Last Updated: Thu Oct 2 04:47:59 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.

home | medical professionals | women | industry | forums | international
e-mail | about us | advertising | our sponsors | contact us | disclaimer |

This information is provided for educational purposes only.
Please read the disclaimer. ©1996-2008, all rights reserved.
Do not reproduce without permission of MediSpecialty.com