Editor's Choice The Ins and Outs of Medical Credentialing Credentialing refers to the process used by hospitals and health plans for approving physicians. Each entity grants approval after reviewing and verifying a physician’s credentials. What may seem like a simple process actually involves tedious paperwork and unnecessary bureaucracy.   Why is the credentialing process so complicated? Because every state, hospital, and insurance company maintains different rules, forms, processes and requirements. You need to learn the special nuances ... Read More Family meetings without the patient present Medicare does not permit a physician practice to bill for family meetings without the patient present.  The physician may not bill Medicare, nor may they bill the family member.  It is fairly common for the spouse or child of a patient to ask to see the physician to discuss the patient's care.  The meetings can be quite lengthy and involve a lot of physician time.  For Medicare, however, unless the patient is present, there is no payment for the service. You may not bill the ... Read More Earning Hospital Privileges: The First Step in Medical Credentialing For a physician to practice at a hospital, he or she must be granted privileges. To receive these privileges, the physician’s credentials are reviewed and verified by the hospital. When this process completes successfully, the physician can treat admitted patients, perform medical procedures and use the facility for patient care. The physician then submits claims to the insurer for providing patient services in the hospital. Hospital privileges are a prerequisite for health plan credent ... Read More The mission of Codapedia™ is to build a community of volunteers (Codapedists) to create the world’s best and most comprehensive resource for coding and reimbursement for physician services.  Codapedia™ will be 100% free, with costs underwritten by advertising.