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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
  • Urgent Care
  • Speech Therapy
  • Geriatric Medicine
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Genetic Testing
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • 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
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Practices Served

  • Behavioral Health
  • DME
  • Urgent Care
  • Speech Therapy
  • Geriatric Medicine
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Genetic Testing
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • 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

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  • A White, Male Medical Doctor Signing Paperwork. Sitting at a desk.

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