DRZIVAR

7+ Year Member
Nov 9, 2009
30
0
Los Angeles, California
www.codingorganization.com
Status
Resident [Any Field]
Is board certification or board eligibility necessary to for private insurances? I am trying to get a job at a general practice clinic and while asking some clinicians one told me that in order to be certified and bill private insurances and HMOs a clinician has to be board certified or atleast board eligible? I know hospital privileges are different and certification is needed but I am not sure of this matter? Does anyone know anything or can I check somehow? I am in Georgia.
 

VA Hopeful Dr

Senior Member
15+ Year Member
Jul 28, 2004
20,320
26,004
Status
Attending Physician
Is board certification or board eligibility necessary to for private insurances? I am trying to get a job at a general practice clinic and while asking some clinicians one told me that in order to be certified and bill private insurances and HMOs a clinician has to be board certified or atleast board eligible? I know hospital privileges are different and certification is needed but I am not sure of this matter? Does anyone know anything or can I check somehow? I am in Georgia.
Generally speaking, most insurances require board certification. Only way to be 100% sure is to ask them.

That being said, in today's world its generally a pretty bad idea to not be board certified. I am not participating in any insurance (including Medicare), but I'm maintaining board certification.
 

VA Hopeful Dr

Senior Member
15+ Year Member
Jul 28, 2004
20,320
26,004
Status
Attending Physician
How long have you been in practice and how hard is it for someone to start with that rather than with conventional insurances? May I ask what you do ?
Right at a year, start up wouldn't be too bad if you don't have a huge loan burden - if you do it becomes trickier since you likely won't make much money at first.

I do this (note: not my website but I'm doing the exact same thing): https://atlas.md/dpc-curriculum/
 

styphon

Senior Member
10+ Year Member
15+ Year Member
Jun 25, 2001
713
275
New york
Status
Attending Physician
Is board certification or board eligibility necessary to for private insurances? I am trying to get a job at a general practice clinic and while asking some clinicians one told me that in order to be certified and bill private insurances and HMOs a clinician has to be board certified or atleast board eligible? I know hospital privileges are different and certification is needed but I am not sure of this matter? Does anyone know anything or can I check somehow? I am in Georgia.
In NY, I had our billing ladies ask the insurance companies about BE/BC. Everyone of them required board CERTIFICATION, the fact that I was board eligible did not matter. This also included medicaid along with the private insurances.

I also can not do Workers Comp/No fault exams without being board certified.