• Billing Exams Without Insurance Credentialing


    Question: We have a new physician joining our practice sooner than her license is available and prior to credentialing. Can we bill under the group with a specific modifier? I heard about locum tenens.

    Answer: Hiring a new physician does not qualify for locum tenens. Locum tenens physicians are used in temporary situations of no more than 60 days where the physician of the practice cannot see patients. When attempting to bill under a senior ophthalmologist of the practice, she must be present in the lane and examine the patient directly.

    Learn more about exam billing in Ophthalmic Coding: Learn to Code the Essentials

    Learn more about physician onboarding in the Webinar: Streamlining Your Physician Onboarding Process