Two clocks run on a new role, and only one of them is visible.
The visible clock
Licensure. It has a defined endpoint, a certificate, and everyone in the process is watching it.
The other one
Payer enrollment and credentialing. Per payer, per state, per tax ID, per location. Each has its own forms, its own committee schedule and its own effective date. Several run longer than the license did.
The consequence
A PA can be licensed, credentialed by the hospital, rostered and seeing patients while none of that work is billable. The visits happen. The claims do not pay, or they pay and get recouped later when the effective date is examined.
Some payers backdate an effective date to the application; many will not, and those that do often cap how far back. That variation is worth knowing before a start date is agreed, because it decides whether the first weeks are revenue or write-off.
What to do
Start enrollment in parallel with licensure, accepting that some payers will not open a file without a license number — get everything that can be prepared prepared, so the only remaining step is supplying it.
Ask each payer what their effective-date policy is rather than assuming. And treat this as a distinct discipline: it is handled by our sister team at whiteglovecredentialing.com.
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