At QuickClaimMed, we know credentialing delays can stall your cash flow—but there are ways to keep seeing patients legally while waiting for approval. Here’s how to navigate this challenge without risking denials or compliance issues.
✅ 5 Legal Ways to Operate During Credentialing Delays
Option How It Works Billing Implications
Temporary Privileges Hospitals may grant 30-90 day provisional status Some payers (like Medicare) may reimburse—but not guaranteed
Supervised Practice Non-credentialed MD works under a credentialed provider Bill under supervising physician’s NPI
Emergency Care Only for urgent/emergent cases (not routine visits) Medicare often pays, but documentation must prove medical necessity
Cash/Out-of-Network Patient pays upfront; may submit for OON reimbursement No insurance billing—practice collects full fees
Telehealth If licensed in the state (but not credentialed with payer) Check payer rules—some Medicaid programs allow it
🚫 3 Risks of Seeing Patients Pre-Credentialing
Claims Denials – Insurers won’t pay for services rendered before credentialing date.
Can a Non-Credentialed Physician See Patients?
Yes—but with major caveats. While providers can treat patients pre-credentialing, insurance won’t pay until the process is complete.
Patient Backlash – Surprise bills if they expect insurance coverage.
Compliance Violations – Potential fines if misrepresenting provider status.
QuickClaimMed’s Pro Tips to Minimize Revenue Loss
- Use “Incident-To” Billing (Medicare & Private Payers)
If a non-credentialed physician assists a credentialed provider, bill under the credentialed provider’s NPI.
Requirements:
Credentialed provider must initiate care
Supervising provider must be on-site (for non-MDs)
Services must be part of an established treatment plan
- Leverage Temporary Privileges
Many hospitals offer 90-day provisional credentialing while paperwork processes.
Verify with each payer if they honor temporary status.
- Offer Discounted Self-Pay Rates
Transparently explain: “Dr. Smith is in credentialing—self-pay rate is
X
(
v
s
.
X(vs.Y after insurance approval).”
Provide a superbill for patients to self-submit to insurance.
- Prioritize Fast-Track Credentialing
Average processing time: 60-120 days (90+ for Medicare).
Our credentialing service cuts this to 30-45 days by:
Pre-verifying documents
Tracking application status daily
Escalating delays with payers
“What If We Already Saw Patients Pre-Credentialing?” Damage Control
Hold Claims – Don’t submit until credentialing is approved (backdating claims = fraud).
Convert to Self-Pay – Contact patients to settle balances (offer payment plans).
Appeal Denials – If claims were rejected, we can help resubmit post-approval.
Need Help Avoiding Credentialing Delays?
QuickClaimMed ensures:
✅ Faster credentialing (30-45 days avg.)
✅ No missed revenue with compliant billing workarounds
✅ Zero compliance risks—we handle all paperwork
Book a free credentialing consult today:
🌐 quickclaimmed.com
