Wiki Credentialing

[Pkirsch1]

Good Morning,
We have a provider that just got licensed. We bill out under our group practice. Does that mean that this provider does NOT need to be credentialed?

Thank you,
Pam

 

[Heatherc7]

Hi Pam,

A claim will always go out with the Individual Provider NPI as the Rendering Provider and the Group NPI and TIN will be under Box 33 for payment. Yes, the provider needs to be credentialed, or the claim will not be paid.

Warmly,

H