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April 1999

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Subject:
From:
Jon Anderson <[log in to unmask]>
Reply To:
UVM Flownet <[log in to unmask]>
Date:
Thu, 8 Apr 1999 22:52:27 PDT
Content-Type:
text/plain
Parts/Attachments:
text/plain (123 lines)
>From: Bill Schroedter <[log in to unmask]>
>Reply-To: UVM Flownet <[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: On Call Interpretations
>Date: Thu, 8 Apr 1999 14:26:21 -0700
>
>     Is heparin started prior to the formal interp? Or is the patient
>     sent home?  When clinical decisions are based upon the
>     "preliminary" interpretation, do you give the professional
>     component to the technologist?
>
>     Gotta agree with Bob. If it is emergent anough to get the
>     technologist out of bed, it should be emergent enough to get the
>     doc out of bed. Preferrably, the vascular specialist to see the
>     patient prior to even ordering an test. I am not completely sure
>     about the rules (maybe someone can help me here) but I believe
>     there is some requirement for payment that the interpretation be
>     contemporaneous. That is, if the patient has already been
treated
>     and/or clinical decisions made, billing for that interpretation
>     is considered fraudulent, or at least that is the way I
>     understand it.
>
>     To take a stab at the question Bob asks, "what should be
>     done?"........well, let me answer it this way. I think that the
>     only emergent test is one where the vascular surgeon is tapping
>     his fingers waiting to take the patient to the OR. Otherwise, it
>     can be done at 7 AM during normal operating hours.
>
>
>     Bill Schroedter
>     Venice,FL.
>
>
>______________________________ Reply Separator
_________________________________
>Subject: Re: On Call Interpretations
>Author:  UVM Flownet <[log in to unmask]> at Internet
>Date:    4/8/99 11:18 AM
>
>
>     Dr. Holtz
>
>     I am afraid you've hit my pet peeve button.
>
>     It is my understanding that "legally", a preliminary report
remains
>     such until ALL data (worksheets; photos; VCR, etc) obtained
from the
>     exam has been provided to the reading physician for
interpretation.
>
>     After ALL of this material has been made available to the
reading
>     physician, and a formal report dictated, the preliminary report
>     process is complete.
>
>     What has been done nationally is to use the preliminary report
process
>     to defer formal interpretations under the pretence that
sonographers
>     have to decide what images to capture in order to complete the
exam as
>     defined by protocol.
>
>     Unfortunately, patients are not deferred treatment until the
formal
>     interpretation process has been complete.
>
>     "On call" procedures, by my definition, are examinations that
are of
>     an emergent nature and can not wait until normal hours of
operation.
>     It is bad enough to delay the formal report process during
normal
>     (non-emergent?) working hours.
>
>     Does it matter?  Do sonographers give better "preliminary
reports"
>     than physicians give formal interpretations?  Are all
sonographers
>     certified?  Are all reading physicians qualified?  Would you
want your
>     mother or wife treated, or not treated, for a vascular issue on
the
>     bases of a preliminary report?
>
>     Questions that make blood boil and my pet peeve button SCREAM.
>
>     This issue is not what IS done, but what SHOULD be done.
>
>     Bob Scissons, RVT
>     Toledo, Ohio
>
>
>
>______________________________ Reply Separator
>_________________________________
>Subject: On Call Interpretations
>Author:  "[log in to unmask]" [SMTP:[log in to unmask]] at PHS
>Date:    4/7/99 10:10 PM
>
>
>  Please give me some input as to how the on call vascular
procedures are
>read.
>      Our hospital is a 200 bed general hospital with a dedicated
vascular
>lab.
>       We have two vascular surgeons alternating weeks reading. The
>radiologists read some carotids.
>        The technologists give a prelm. report and a formal reading
is done
>the next day.
>          What is done at other hospitals????  Of comparable size?
>        Thanks in advance for your input.
>                                                      Richard A.
Holtz D.O.


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