Medical Billing
The doctors raising certain specialties and for specified acts (cares of first intention) can be consulted without previous consultation of the treating doctor while remaining in the journey of cares and paid as such.
Field of the specific access:
Are concerned certain acts in gynecology and ophthalmology.
For the gynecology, the cares being able to give place to a specific access are:
- the examinations clinics periodic gynecologic, understanding the screening acts, in accordance with the referential scientists elaborated by the High Authority of health;
- the prescription and followed it by a contraception in accordance with the referential scientists elaborated by the high authority;
- followed it by pregnancies;
- The voluntary interruption of medicinal pregnancy.
While waiting for the publication of the referential scientists elaborated by the High Authority of medical health, these cares will be considered as coordinated, to the direction of the paragraph of the presents convention.
For the ophthalmology, the cares being able to give place to a specific access are:
- the disturbances of the medical refraction eyepiece (prescription and renewal of corrective glasses), in accordance with a referential one to define;
- The acts of screening and of followed by the glaucoma.
While waiting for the publication of this referential one, these cares will be considered as coordinated, to the direction of the presents convention.
For the psychiatry, psychiatry and the neurology, the parties suit to determine the conditions in which ones certain cares will be able to give place to an access specific by conventional avenged at the latest the 1st March 2005. While waiting for the publication of this avenged, the access to the psychiatrists, psychiatrists and neurologists is considered as specific for the body of the medical billing software that they give.
In the described positions above, the doctor specialist is been anxious the same engagements in terms of coordination that the corresponding doctor. It appreciates the counselor necessity to his patient to consult his treating doctor.
Methods of remuneration of the doctor specialist consulted in specific access:
From that time that they are integrated to the journey of coordinated cares and that their engagements are the same as those of the corresponding doctor, notably while proceeding to an information return to the treating doctor, the general practitioners in registered specific accesses to tariffs opposables or having adhered to the coordination option benefit from the increase of described coordination to the point 1.2.2.
Functioning of the journey of coordinated cares:
The different methods of the journey of coordinated cares:
The treating doctor assures the current cares of the patient that chose it as such. In certain positions nevertheless, the treating doctor can call upon a corresponding doctor.
The different methods of the journey of coordinated cares are the following:
Treating doctor towards corresponding doctor for asks punctual opinion:
The corresponding doctor has a role of consultant one, according to defined methods to the point 1.2.2 present text. To this title, it does not give any continuous cares to this patient and must leave to the doctor treating the in charge of overseeing the application of its prescriptions.
Treating doctor towards corresponding doctor for repeated cares:
These cares are practiced according to:
- a care plan predefined in terms of content and of periodicity between the treating doctor and the corresponding doctor;
- Or according to a protocol affection long-term.
The patient attains the corresponding doctors without passage by the treating doctor according to the predefined periodical.
Treating doctor towards corresponding doctor with necessity of a sequence of cares necessitating one or more participants:
This care sequence is realized in consultation with the treating doctor. The patient then is oriented towards the corresponding doctors without passage by the treating doctor.
Treating doctor towards non-specialized corresponding doctor (notably MEP) :
The treating doctor can counsel a care sequence to his patient necessitating the punctual or repeated intervention care plan) of a non specialized doctor.