Adding a new surgeon

tneal123

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GRANITE FALLS, NC
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Does anyone know if a surgeon can perform surgeries if they are not credentialed with the insurance yet? We would maybe hold the charges expecting that the effective date would be retro. Any advice would be appreciated. New doctor starting 12/1/08. Thank you. :confused:
 

mbort

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ENGLEWOOD/DENVER
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He can perform them but he will be considered "out of network" . It would be appropriate for him to notify patients of this prior to scheduling them for surgery as well.
 

WendyCPC

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We do alot of credentialing and the best advice I can give you is to start the credentialing process ASAP. If you are adding him to an existing group it should not take as long though. Some ins companies will retro to the start date you put on the application even if it takes a couple of weeks to approve you can hold the claims and you should be ok.
 

jenpollock

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I agree w/mbort also. We have only have Medicare actually retro the effective date, even some insurances told us they would and then didn't!
 
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