Does your credentialing transfer when you open your own practice?

Mostly no. You keep your license and your individual NPI. Your new practice has to get credentialed and contracted with every payer from scratch.

The reason trips up a lot of doctors. Being "in-network" was your old group's contract with each payer, tied to the group's tax ID, with you listed as a provider under it. Your new practice is a separate business with its own tax ID, so every payer treats it as a new applicant. You can be fully credentialed as a physician and still have no way to bill as a practice.

Here is what carries over and what does not:

Medicare needs its own paperwork: an 855B for the group, your 855I, and an 855R to move your billing to the new practice.

Timing is where the money gets lost. You cannot bill as in-network until your effective date, but the filing clock starts the day you see the patient either way. So you treat patients while you wait, and any claim that ages out before you go active is money you never collect. Backdating barely helps: Medicare goes back 30 days at most, most commercial plans none. The move is to start early and keep enough cash to get through the wait.

You form the entity and get the NPIs. Altair takes it from there. The AI, backed by our expert in-house billers, handles the re-credentialing and enrollment for the new practice, Medicare, Medicaid, and commercial, then runs the billing behind it. One team owns both, so claims go out on the right dates instead of piling up in denials, and you can watch it happen.

Talk to us before you open, and the billing is handled from day one.

Common questions

Sources: CMS NPI Fact Sheet, CMS-855 forms, 42 CFR 424.44, CAQH ProView guidance.