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Click here for more sample CPC practice exam questions and answers with full rationale

New provider not credentialed with health plans

Hi there,

We have a new provider (an MD – not an NP) who is not quite credentialed with all the health plans our practice participates with. When she sees patients who have an insurance she is not credentialed with, I have been directed to bill those claims under another physician at the practice. Is this acceptable? If anyone can provide me with some guidance on this I would appreciate it greatly!!

-Caitlin

Medical Billing and Coding Forum