What organization told you board certification is necessary for reimbursement? I'm sure Medicare doesn't have any requirement for board certification, and although private health plans might have such a requirement I suspect it would frequently be negotiable to include board eligible. If the doctor is reading for hospitals, medical staff credentialing might be a bit more challenging.
In the dark ages when I first started many physicians were never board certified, and board certification didn't occur until after completion of training, so it was quite normal to credential board eligible physicians. I do believe the value of board certification has been overblown because it's an easy checkbox and there is a lot of money being made by the certifying bodies.
I don't think having another provider sign off his reports would change anything, since when you submit a claim you attest that the rendering provider personally performed the work. I don't believe it would be appropriate to bill in a different physicians name just for a signature.
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David Smith FACMPE
Executive Director
United Imaging Consultants
Mission KS
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Original Message:
Sent: 02-27-2024 12:11
From: Lisa Dudley
Subject: Board Eligible Radiologist
Good afternoon,
I am looking for advice on credentialing a board eligible radiologist.
I spoke to provider credentialing regarding board certifications and credentialing. I was told, in general the same thing, we can start the credentialing process, however, the provider will not be paid for any services rendered until he passes his boards, they receive his certification, and his credentialing is then considered fully complete. I am guessing that we would have to have a supervising radiologist sign off on all his charts in order to bill for his/her services?
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Lisa Dudley
President and CEO
Meridian Financial Management, Inc
Millersville MD
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