Billing for Non-par provider

[KimGailey]

Does a Dr have to complete credentialing with the insurance company to file a claim with them?  If they don't do the credentialing, wouldn't it just be out of network?

[Pay_My_Claims]

yes, not credentialed = non par

[Michele]

Some plans do not have out of network benefits so submitting the claim doesn't always  mean payment will be made.  But you should always file to be sure.

[Priyan]

For Traditonal insurance like Medicare and Medicaid we cannot send an claim form to them untill we are credentialized