Billing > Billing

Billing for Non-par provider

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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

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