Glossary
Effective Date
The date on which a provider's network participation or payer enrollment formally begins and billing for covered patients can start.
The effective date marks when a provider's contract or enrollment with a payer takes effect, establishing the point from which services rendered to that plan's members can be billed in-network. Services delivered before this date are generally not payable under the agreement, so confirming it is critical to avoid uncollectible work. In some cases a payer permits a retro-effective date, which enables retroactive billing; otherwise a provider must wait until the effective date to begin seeing patients as a participating provider.