The Connected Practice

Why Physician Groups Lose 1 in 8 Consult Claims

Hosted by Dr. Kevin Halow, MD MBA FACS
S2 · Ep16 · 7:11
Why Physician Groups Lose 1 in 8 Consult Claims | Podcast

What You'll Learn in This Episode

Why 1 in 8 Consult Claims Can Be Lost

Understand how physician groups can lose consult revenue because of communication and documentation breakdowns—not necessarily because the consult itself was invalid or never occurred.

How Handoffs Affect Physician Reimbursement

Learn how consult information moves between physicians, schedulers, coders, billers, and payers, and how a missed handoff can cause a claim to be delayed, denied, or ultimately written off.

The Hidden Cost of Fragmented Communication

Explore how relying on phone calls, emails, faxes, and different EMR systems can make it difficult to maintain a complete and reliable record of a consult.

Why Documentation Matters After the Consult

Understand why completing the clinical work is only part of the process, and how missing documentation or incomplete communication can prevent practices from properly capturing the work that has already been performed.

How Communication Breakdowns Create Revenue Loss

Learn how seemingly small issues—such as missed callbacks, delayed notes, or information getting stuck between departments—can accumulate into significant financial losses for physician practices.

A Real-World Example of Coordination Failure

Explore Dr. Kevin Halow’s experience coordinating a complex surgical case and how communication gaps between practices, schedulers, primary care offices, anesthesiology, and operating rooms can create costly bottlenecks.

How a Shared Communication Record Can Help

Learn how keeping the consult request, specialist response, timestamps, and communication history together can make it easier to verify what happened and support a cleaner billing workflow.

How ClinicianCore Approaches Consult Communication

Discover how ClinicianCore’s HCO Practice HQ is designed to keep consult communication and documentation in one trusted place, helping practices reduce missed handoffs, administrative friction, and lost revenue.

About This Episode

In this episode of The Connected Practice, Dr. Kevin Halow, surgeon, veteran, co-founder and Chief Medical Officer of ClinicianCore, examines why physician groups can lose consult revenue because of communication and documentation breakdowns.
Dr. Halow explains how a consult can move through multiple handoffs—from the physician and scheduler to the coder, biller, and payer—and how a single missed handoff can disrupt the entire process. The clinical work may be completed, but if the documentation and communication surrounding it do not make it through the workflow, the practice can still lose reimbursement.
The episode explores the hidden problems created by fragmented communication, delayed documentation, missed callbacks, and disconnected EMR systems. Dr. Halow also shares a real-world example involving a complex surgical case to demonstrate how coordination failures can affect not only billing, but also scheduling, operating room efficiency, staff workload, and patient experience.
The discussion ultimately reframes lost consult claims as a handoff problem rather than simply a billing problem. By creating a shared and traceable communication record, practices can better preserve consult documentation and ensure that the request, response, and supporting information remain connected throughout the workflow.
The episode also introduces ClinicianCore’s approach to centralized clinical communication and documentation through HCO Practice HQ, designed to help practices reduce communication gaps and protect the value of the clinical work they have already performed.

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