CMISP Frequently Asked Provider Questions

To which pharmacy can I send the patient?
CMISP patients can take their prescription to the County's Pharmacy located at 4600 Broadway, Monday - Friday 8:00 a.m to 5:00 p.m.

To which laboratory can I send the patient?
CMISP uses Quest Diagnostics.  

How do I get authorization for surgery?
A written request is sent to Medical Case Management indicating the reason for surgery. This can also be included as part of the consultation report.

What do I do if the patient fails to show up for his appointment?
Contact Medical Case Management and they will try to contact the patient for you to reschedule an appointment. Return the authorization form to Case Management indicating the "No Show" status of the appointment.  For CPT codes 99241-45 and for CTP codes 99211-215, there is a reimbursement rate of $25.00 per "No-Show" visit. 

How do I schedule a diagnostic test for a patient?
Contact Medical Case Management to schedule any diagnostic test.

How does a private patient get on the CMIS program? 
Have the patient go to the County Primary Care Center at 4600 Broadway. 

What if there is an authorization for service on the consult package that we will not perform?
Even though it is on the authorization form, only bill for the exact service rendered.

What if the provider wants to do an additional procedure not on the package?
Call Medical Case Management for prior authorization. If authorization is given, include that service on your bill using the same authorization number for the consult. Also, advise Case Management of the appropriate CPT coding for the procedure(s).

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