NOV 14, 2023
Co-management With Nonparticipating Optometrist
When the referring optometrist’s office does not participate with a medical plan, are surgeons allowed to globally bill for cataract surgery and have the optometrist submit invoices for their co-managed portion to the surgeon for payment?
Answer:If an optometrist does not participate with the insurance, they cannot provide co-managment. Each party independently bills for the appropriate number of post-op days they provide. Payments from the surgeon to the optometrist may be viewed as a violation of federal anti-kickback statutes.
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