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  • What’s the Difference Between (Medical Billing and Credentialing)?

What’s the Difference Between (Medical Billing and Credentialing)?

August 7, 2017 / admin / Articles, Billing, Credentialing, Medical Billing, Payer Enrollment, Payor Contracting, Pittsburgh Credentialing
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Medical Doctor Costs

Medical Billing and Credentialing Differences

Medical billing and credentialing for medical providers are two different categories in the healthcare world. Before any medical billing can even be completed, the healthcare provider needs to be credentialed with insurance companies in order to be an approved provider of services. Becoming credentialed as an in-network provider dictates the set amount of reimbursement that provider can expect back.

After the credentialing process has been completed the healthcare provider is then able to start treating patients in that network and sending claims for reimbursement. A medical biller will use CPT and ICD-10 codes on the claim to describe to the insurance companies what treatment the provider has given. They will then follow up on the claim to make sure that it has been properly paid by the insurance company.

At Medwave Billing & Credentialing, we know the difference and strive to provide the best billing and credentialing, at the right rate.

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Practices Served

  • Behavioral Health
  • DME
  • Genetic Testing
  • Urgent Care
  • Pharmacogenetic (PGx) Testing
  • Toxicology
  • Substance Abuse
  • Allergy Testing
  • Speech Therapy
  • Skilled Nursing Facilities
  • Oncology
  • Pathology
  • Internal Medicine
  • OBGYN
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Practices Served

  • Behavioral Health
  • DME
  • Genetic Testing
  • Urgent Care
  • Pharmacogenetic (PGx) Testing
  • Toxicology
  • Substance Abuse
  • Allergy Testing
  • Speech Therapy
  • Skilled Nursing Facilities
  • Oncology
  • Pathology
  • Internal Medicine
  • OBGYN
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Recent Posts

  • One Big Beautiful Bill Act Outcomes

    Medicaid Changes Under The One Big Beautiful Bill Act

  • Indian Woman Physician Assistant Needing Credentialing

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  • California Medical Billing, Credentialing

    California Medical Billing: Golden State’s Complex Healthcare Landscape

  • Medical Credentialing Engine Fueling American Healthcare

    Credentialing: Fueling America’s Healthcare Engine

  • Texas Medical Billing, Credentialing

    Texas Medical Billing & Credentialing Solutions

  • White Male Medical Credentialing Company Owner

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