Collaborative Patient Care is a Provider Partnership

As a physician, supplier, or other health care provider, you may need to collaborate with other providers when providing care to your Medicare patients. For example, you may write orders, make referrals, and request health care services or items for your patients. It’s important to understand Medicare coverage criteria and documentation requirements that apply for those services or items to help ensure quality care for your patient and accurate and timely processing and payment. Learn about coverage criteria and documentation when you partner with others to care for your patient.

  • If you don’t provide enough information to support medical necessity when you refer or write orders, the other provider or supplier may not get paid, which can cause delays or no treatment for your patient.
  • You must provide documentation and information to other health care providers to support their claims for services or items.
  • You can give protected health information, without patient authorization, to other health care providers covered under the privacy rule to carry out treatment, payment, or health care operations.

Resource: CMS MLN Fact Sheet Learn Collaborative Patient Care is a Provider Partnership

Source: CMS MLN Connects dated April 14, 2022


Last Updated Apr 14 , 2022