Resources

Credentialing is how an insurance company verifies your education, training, licenses, work history and malpractice coverage before it will contract with you. Enrollment is registering with Medicare, Medicaid, TRICARE and Railroad Medicare so you can bill them; it means the program recognizes you, but it is not a contract.

Being enrolled in Medicare does not let you see Medicare Advantage patients. Those plans belong to specific carriers and each needs its own contract. One missing document can stall an application for weeks, so start early and keep copies of everything.

If this is the part of practice ownership that's slowing you down, request a free consultation and we'll sort it out together.

Once a carrier credentials you, the contract sets what you get paid and when, for years. Negotiation over rates and covered services is the step that matters most. After signing, the carrier loads you into its system so claims can pay.

I review every section before you sign, stay with it through loading, and make sure you have the executed contract, confirmation it's loaded, and your expected reimbursement for your top 30 codes, so billing problems surface in the first few weeks instead of six months in.

If you're about to sign a contract, or you signed one years ago and haven't looked at it since, request a free consultation.

Most insurance contracts don't come with the keys. Medicare and Medicaid have formal change-of-ownership processes, and some enrollments can carry over depending on the state and how the sale is structured. Commercial carriers treat contracts as personal agreements: most require written consent to transfer, some refuse, and the new owner often starts credentialing from scratch.

Plan the credentialing months before closing so there's no gap where you can't bill, don't promise a buyer the contracts will transfer, and have a healthcare attorney review the assignment language.

Rules vary by state and change over time. This is general information, not legal advice.

If a purchase or sale is on your horizon, request a free consultation well before the closing date.