Explaining Ancillary Services and the Role of Carlisle Medical

Released: 03/28/2022  

The term ancillary encompasses all of the services that are designed to support the work of the primary care physician. When an employee is injured, they more than likely will need more than just a prescription for their recovery. They may need medical supplies like sterile gauze or crutches, transportation to medical appointments, help understand the doctors’ orders or another type of support. The care associated with these ancillary requirements varies from a simple, one-time request, to more intricate, long-term needs. These supplies are generally not provided by acute care hospitals, doctors, or health care professionals.

Ancillary service providers have been around for as long as physicians have been practicing in the medical field. Ancillary providers range from manufacturers churning out millions of packages of bandages per day, to small custom prosthetic shops and exist in high numbers all over the country. As new procedures in medicine require specific types of supplies and equipment, a whole industry was born to research, develop, and manufacture these products. A few examples of ancillary care include Outpatient Surgery, Transportation, MRI, DME (Durable Medical Equipment and Supplies), Wound Care, and Hearing Aids. In a broad sense, just about anything used in healthcare to improve one’s health outside of physician’s care, fits into the ancillary service category. Doctors and nurses provide the care to improve and keep injured workers healthy but, ancillary providers are an important role to fulfill certain important aspects of the treatment plan goals.

Over the years this industry has grown and become more complex. In the early years of ancillary, the service description and costing were difficult due to there was not a standard. As the industry grew and became more specialized, defining the products and services became more critical, to ensure items were billed properly. Standards were developed for specific products and how to process them for payment. Over twenty years ago, the Center for Medicare and Medicaid began to create a specialized coding system for ancillary services. The main goal was to bill uniformly and define the items accurately. The coding system created and utilized today, is a level II HCPCS that is designed to supplement procedure (CPT) codes. These are the current codes that print on HCFA bills and consist of one letter followed by four digits. This coding system has continued to adapt and defines thousands of individual products/services and today helps to support the billions of transactions that are processed yearly to insurance companies, including many inside workers’ compensation industry.

The service area “Ancillary” has been applied to a significant area of the medical industry. While the managing of claims for this area has been difficult in the past, because of its regional nature, improvements in networks and new legislation has significantly simplified ordering and processing procedures. Carlisle Medical is prepared to assist with a number of workers’ compensation ancillary services including Catastrophic Care, Discharge Planning, Durable Medical Equipment, Medical Supplies, Wound Care, Handicap living Aids, and Hearing Aids.

Please call today at 1-800-553-1783 or click here to contact us to learn more about our service offering.

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