MrsRonSwanson Posted September 6, 2011 Share Posted September 6, 2011 Hi folks, You'll have to excuse me if I posted this in the wrong section as I am pre-PA, but I wanted the opinion of PAs. I saw a PA and had an EKG done in urgent care. The PA went over my blood work and EKG and said everything was fine/normal and I went home. The claim was put in to my insurance company and I paid. I received another bill from a cardiologist who, according to the insurance company, read my EKG and put a claim in. The insurance company told me that the EKG went to the cardiologist, who spoke to the PA, and then the PA spoke with me because PAs work under physicians and PAs are not qualified to read EKGs. This is not true. My whole visit was roughly 15 minutes. The PA read the EKG. I'm following up with the insurance company and clinic as to how/why this cardiologist became involved if my EKG was normal. Is this standard, to forward EKGs onto a physician, especially a normal one? I was under the impression that PAs order, read, and interpret labs/tests. I know PAs have a supervising physician, but can they bill again for what the PA did? As I'm not yet in PA school and don't know the ropes, I would appreciate your input. Thank you! Link to comment Share on other sites More sharing options...
paleanne Posted September 6, 2011 Share Posted September 6, 2011 I've always read my own ekg's and have consulted with my supervising physician if any issues? I work in FP though, so not sure if it's different elsewhere. Link to comment Share on other sites More sharing options...
Sara Wajek Posted September 6, 2011 Share Posted September 6, 2011 Things are probably done differently in different areas, but the clinic I work for (I'm a lab tech, not a PA) has "reading" doctors that do the official read and report of the EKG and are the ones that bill for the service. Since they don't read and report the results immediately a copy is often sent to the ordering provider so they can look it over, especially in an urgent care setting. This is probably what happened in your situation. The PA looked it over while you were present and didn't see any problems but the official report was done by a cardiologist at a later time and that's the doctor that billed for the service. Link to comment Share on other sites More sharing options...
flyingsquirrel Posted September 6, 2011 Share Posted September 6, 2011 Sara basically said it. The PA read the EKG the same way that EM physicians read EKGs. They are trained to look for the big bad things that will cause a patient problems in the next 24 hours and then an official read by a cardiologist/electrophysiologist happens sometime in the next day or two. The same thing happens with x-rays and CT scans...the PA/MD/DO does a preliminary read and then they are officially read and interpreted by a radiologist. The PA is being treated no differently than a physician in the same situation. And yes, they can bill for both, but depending on your insurance you might not have a seperate copay. Link to comment Share on other sites More sharing options...
MrsRonSwanson Posted September 6, 2011 Author Share Posted September 6, 2011 Thanks for the answer. So, it sounds like my insurance will end up having a separate co-pay for both. Link to comment Share on other sites More sharing options...
taotaox1 Posted September 6, 2011 Share Posted September 6, 2011 I work as an EKG technician and I can confirm it is exactly like flying squirrel said it. We (the techs) do the ekgs and then the attending physician/pa/np will check them them out. They are then all sent to the cardiologists who check them for the more serious underlying issues beyond disrythmias etc. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 6, 2011 Moderator Share Posted September 6, 2011 yup, pa's can read ekg's and xrays but just like with docs many places still require an over read done by a cardiologist or radiologist. Link to comment Share on other sites More sharing options...
MrsRonSwanson Posted September 7, 2011 Author Share Posted September 7, 2011 It appears that having a cardiologist look over it is protocol. Fine, not a problem, but is billing separate common practice? As a patient, I find it rather ridiculous that I was billed for an urgent care visit and a cardiologist office visit (to look over the EKG) and thus had to pay two co-pays. If a cardiologist has to look over it anyway, I would imagine that would somehow be grouped in with the original urgent care visit. I mean, if I have to pay a co-pay for a cardiologist office visit to look over my EKG anyway, then I would have liked a proper 15 minute appointment with her so I could hound her with questions. Is there a way to opt out of this practice, as a patient? If a patient is content with the urgent care providers interpretation, why send it on to a cardiologist? I'm just really bitter about this. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted September 7, 2011 Administrator Share Posted September 7, 2011 Complain to your insurance provider about how they're doing "co pays". Co-pays are an artifact of the insurance business, where you or your company pays a certain amount of money up front to an insurance company, whose economic success rests on them being able to collect more from you and the entity that pays your premiums than they have to pay out to the medical providers who render services to you. Link to comment Share on other sites More sharing options...
delco714 Posted September 7, 2011 Share Posted September 7, 2011 I know I work in pediatrics (as an ma while in school) but when we do ekgs the docs read them then we fax them to a cardiologist to second opinion them. They are usually sent back with interpretation the same day. Cardiologist doesn't bill them or anything. dunno how the practice you go to works though! Sounds odd Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted September 7, 2011 Administrator Share Posted September 7, 2011 Cardiologist doesn't bill them or anything. I highly doubt that. Someone is paying the Cardiologist for reading them. I can guarantee you he or she doesn't do it for free, since each reading is an opportunity to be sued for being wrong. Link to comment Share on other sites More sharing options...
taotaox1 Posted September 7, 2011 Share Posted September 7, 2011 Oh they definitely get paid for reading them........ Link to comment Share on other sites More sharing options...
delco714 Posted September 7, 2011 Share Posted September 7, 2011 He doesn't get paid. What he gets is the consult when ekg is abnormal. We have 20 k pt. 12 k active with 5 md and two cpnp. Lots and lots of consults! Link to comment Share on other sites More sharing options...
Houstonian Posted September 9, 2011 Share Posted September 9, 2011 The cardiologist gets paid for reading the EKG. The insurance company was billed for "EKG interpretation" by the cardiologist, in addition to the urgent care bill by the PA. The insurance company is now billing you for both of the charges. An EKG interpretation is a professional fee for services rendered, but is different from a professional fee for an office visit. Link to comment Share on other sites More sharing options...
SocialMedicine Posted September 10, 2011 Share Posted September 10, 2011 Interesting ... i was not aware someone could bill for a remote EKG read. I bet alot of insurance issues arise out of this. As far as PA reading EKGs go .... it is a daily part of medicine practice and you need a strong knowledge of it to be a successful PA. I spent alot of time post school working on this skill. Still do. Link to comment Share on other sites More sharing options...
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