Outpatient Facility Coding Alert - 2008 Issue 37
Reader Question: Hold Claims When Waiting for Physician's Credentials to Come Through
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Article Overview
This article explains how practices may handle billing when newly hired physicians are still waiting for Medicare credentialing, with brief guidance on payer-specific timing considerations and how practices can prepare in advance. It is written for billing staff, coders, and practice administrators who need a general understanding of claim holding, enrollment timing, and coordination with Medicare and other payers.
Why This Topic Matters
Credentialing delays can affect when services may be billed and when payment may begin, so practices need to understand the general workflow before new physicians start seeing patients. The article helps readers identify the administrative issues that can delay reimbursement and the need to coordinate with payer requirements.
What You Will Learn
- How the article frames Medicare credentialing delays for newly hired physicians
- Why payer-specific enrollment timing matters for billing
- What general operational issues practices should consider while waiting for credentialing completion
- Why advance planning is important before a physician starts seeing patients
Who Should Read This
- Medical billers
- Coders
- Practice administrators
- Revenue cycle staff
- Physician office managers
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