Does holding a license guarantee that a practitioner can obtain third-party payment for his or her services?
• Holding a license in any human service profession, including medicine, does not guarantee the professional the right to bill a specific third-party insurance carrier for their services. Insurance carriers establish a “Provider Panel” for each profession based upon the need within a specific geography. The carriers work to limit the number of approved providers to the minimum that will meet these needs in a cost saving effort. Qualified providers are required to apply to become a member of the Provider Panel and may or may not be accepted. However, if the provider does not meet the standards of the carrier, they surely will not be included on the panel.
