From time-to-time it is necessary to augment the county contracted physicians with non-contract physicians because there is not sufficient coverage for specialty care. Examples of shortages include, but are not limited to, pediatric on-call coverage, gastroenterology, neurosurgery and dermatopathology. These specialists provide emergency backup when no other medical coverage is available.
This resolution will authorize the Controller to pay all on-call specialists, including gastroenterologists, neurosurgeons, and dermatopathology who provide emergency backup when no other medical coverage is available, at 60% of their billed inpatient charges and 50% of their billed outpatient charges or the prevailing Medicare Fee Schedule for San Mateo County. For surgical assists payment is to be made at prevailing Medicare fee schedule for assists which in 2005 equals 15% of the Medicare allowable for the surgery itself.
If on-call specialists are not available, patients needing these services will be required to be transferred to other providers at a considerably higher county expense. All services are pre-approved through the Case Management unit of the Hospital.
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