Outpatient Facility Coding Alert - 2010 Issue 27
Reader Questions: Get the Scoop on Billing Before Credentialing
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Article Overview
This reader Q&A discusses when a practice may begin billing for a new physician while credentialing is still in progress. It addresses Medicare enrollment timing, differences among private payer policies, and general workflow considerations for practices onboarding a replacement clinician. The article is useful for billing staff, practice managers, and credentialing personnel who need a high-level understanding of payer timing issues.
Why This Topic Matters
Timing billing and credentialing correctly can affect claim acceptance and cash flow when a new physician joins a practice. Understanding the broad differences between Medicare and private payer handling helps practices reduce avoidable billing interruptions.
What You Will Learn
- How billing timing can relate to physician credentialing status
- How Medicare enrollment timing is discussed in relation to billing
- Why private payer policies may differ from Medicare and from each other
- General considerations for onboarding a replacement physician while credentialing is pending
Who Should Read This
- Medical billers
- Practice managers
- Credentialing staff
- Physician office administrators
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