Other ins using Medicare Guidelines for Consultations

We were told that Medicare HMO per United Health is using Medicare guideline rules for consultations. Has any one heard if there are other Medicare HMOs going by the new Medicare guidelines for consultations?

Also Humana?

I would guess yes

the link below is United Health's memo about it. They will continue to honor for commercial plans but follow CMS for Medicare HMO's. I think the ithers are also obligated to follow the CMS directive.
https://unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/News/2010/ConsultationCode_Update.pdf

Signature doc response to me about Medicare Consults

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That's UHC for you

The certificate is bad but then again so is UHC. I get the same error and clicked thru it and I am still alive and my computer works.

Here is the pertinent paragraph; For UnitedHealthcare Medicare Solutions, including SecureHorizons®, AARP®
MedicareComplete®, Evercare®, and AmeriChoice® Medicare Advantage benefit plans, these
plans will follow CMS regulations and implement the change, effective January 1, 2010. The
change also includes the revalued relative-value units (RVUs) for E&M CPT codes and a new
coding edit, consistent with CMS, to deny the CPT consult code as a non-payable service.

consult codes for commercial insurers

In Ohio, we received word from Anthem BCBS that consult fees would be paid UNLESS the provider's agreement was tied to traditional Medicare (ie fee payment figured on a specific % above Medicare) -- but "commercial stance may change in the future as this is under review". For us, this means no consult fees with Anthem. SummaCare in Ohio also applying no consult codes across all product lines.

Other ins using Medicare Guidelines for Consultations

We have received denials from Evercare (med adv program), Secure Horizons, and Humana Gold. So the MedAdvantage plans are jumping on the bandwagon.