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Questions and Articles

1,274 items

If a physician prescribes whole cow’s milk as a substitute for breast milk for an infant under 12 months of age, is the meal reimbursable?

A:
Yes, a meal or snack containing whole fluid cow's milk and served to an infant under 12 months of age is eligible for reimbursement if the substitution is authorized, in writing, by a recognized medical authority. Similarly, if a recognized medical a ... more

Can a physician post or pre date a prescription?

A:
A. No controlled substance prescription may be legally pre-dated or post-dated. Federal regulations require that a controlled substance prescription be dated with the date of issuance. ... more

Have physician assistants been accepted on the health care team?

A:
A. Most physicians who have worked with physician assistants like having PAs on staff. The American Medical Association, the American College of Surgeons, the American Academy of Family Physicians, the American College of Physicians, and other medica ... more

What does a Physician Assistant do?

A:
A. As part of their responsibilities, physician assistants perform physical exams, diagnose illnesses, develop and carry out treatment plans, order and interpret lab tests, suture lacerations, apply casts, assist in surgery, provide patient education ... more

What can a supplier do if the patient does not get in to see the treating physician within the 31 st-91 st day?

A:
If the patient received the re-evaluation at a later date and it was documented that the patient was benefiting from the use of the PAP device, the supplier may begin submitting claims with the KX modifier from the date of that re-evaluation. Claims ... more

Is the physician certification form necessary for each leg of the round trip?

A:
Non-emergency ambulette transportation regulated by Medicaid requires each leg of the trip have a completed physician certification form prior to the transport. ... more

The treating physician has finally released the claimant to return to work but has limited his work to light or sedentary. What do I do now?

A:
You must first determine whether the restrictions are medically correct. Get a second opinion on the restrictions, if any, to be placed on the employee. Once you are satisfied with the restrictions assigned to the claimant, you should check with the ... more

I received a report from the treating physician assigning a 15% whole person disability. How does this translate into benefits we must pay to the injured employee?

A:
We do not pay indemnity benefits based on a "whole person" impairment. There are two possible areas of the benefit law that may apply to your case. Assuming that the employee, even with this impairment, is able to earn 90% of his pre-accident earning ... more
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