eConsult Billing and Consent
As a part of the eConsult process at Seattle Children's, the provider placing the order must confirm they have obtained patient and/or family consent. We have provided a suggested script and additional details about billing to assist you with this process.
The most updated version of this document can be found on our Healthcare Professionals page for EpicCare Link and eConsults.
As a part of the eConsult process at Seattle Children's, the provider placing the order must confirm they have obtained patient and/or family consent. This includes informing the patient and/or their family about the eConsult process and its potential associated costs. This is a requirement for billing these services. Please review the eConsults Frequently Asked Questions (FAQs) for background on the eConsult program and which types of concerns are appropriate for eConsults.
Here is a suggested script for sharing this information with your patient and/or their family and confirming consent to submit an eConsult:
- Explain why you are recommending an eConsult:
To best assess your condition and develop a treatment plan, consulting with a specialist from Seattle Children's would be beneficial. With an eConsult, I will be able to get recommendations from a specialist without you having to visit them in person. - Explain why the eConsult may be a better option than a referral:
I can refer you to a specialist if you prefer, but in many cases, an eConsult will provide us with quicker recommendations, allowing us to start treatment promptly.
Additional Advantages of an eConsult:- Quick access to specialist recommendations
- Potential to reduce unnecessary visits and tests
- In most cases, less out-of-pocket expense
- Tell the patient/family how it works and what to expect:
I will provide important clinical details to the specialist to facilitate their evaluation, and they will respond with written recommendations. This is done via secure electronic communication. I will continue to guide your care, though it is possible that the specialist will recommend a referral to be seen in person. Either way, we can expect to receive a response from the specialist within approximately three business days, after which I will follow up with you. - Make the patient aware of the cost:
Seattle Children’s will charge $105 for most eConsults. Many insurance companies cover eConsults, but you may need to pay a portion of the service fee based on your specific insurance coverage. To get specific coverage information, you can ask your insurance provider about coverage for CPT Code 99451, which is the most likely charge code the specialist will utilize, or additional potential codes 99446-99449. If the specialist recommends a referral, there will be no charge for the eConsult. If you are concerned about cost, Seattle Children’s offers Financial Assistance for eConsults; more information, including an application, can be found on their website, www.seattlechildrens.org.
Additional cost information:- The charge is less than an in-person visit because there is never a facility fee with an eConsult.
- While CPT Codes 99451 and 99446-99449 are the most likely charge codes to be utilized, Seattle Children’s will ensure accurate and appropriate charge codes are applied based on the specific level of service provided in each eConsult, which could be different from those listed here.
- Confirm:
What questions do you have? Would you like to proceed with an eConsult?
In all cases, the patient and/or family must confirm they would like to proceed before a provider can submit the eConsult request.