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New physician not credentialed

  1. #1
    Question New physician not credentialed
    Medical Coding Books
    Is it appropriate for a practice to bill a new physician's (physician new to area & practice-not credentialed) services under a supervising physician before the new physician is credentialled?

    I have always submitted claims for new providers under their own ID's (obviously received denials as non-par) then rebilled the claims after provider is credentialed - doing this eliminated a denial for timely filing and and now I'm wondering if this is the appropriate way to handle this situation.

  2. #2
    Phoenix, AZ
    That is what we used to do but leads to a lot of denials. We then created separate insurance carriers for non-credentialed providers for those insurances (Medicare, etc) who would retro credentialing. For the insurance companies who don't retro credentialing dates, it's better for that provider not to see the patient's unless there is an out of network benefit AND you either tell the patient or you write off the non par portion.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

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