Medical Billing Forum
Billing => Billing => : KimGailey May 11, 2010, 07:24:51 PM
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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?
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yes, not credentialed = non par
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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.
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For Traditonal insurance like Medicare and Medicaid we cannot send an claim form to them untill we are credentialized