Hospital privileges and insurance credentialing are separate but related processes. Hospital credentialing grants permission to admit and treat patients at that facility, while insurance credentialing allows billing that insurer for services. Many insurance companies require active hospital privileges as part of their credentialing criteria, viewing hospital affiliation as validation of clinical competence. Loss of hospital […]
Managing patient collections requires balancing financial needs with patient relationships. Options include offering payment plans with manageable monthly installments, providing financial assistance programs for qualifying patients, negotiating reduced lump-sum settlements, or referring accounts to collection agencies as a last resort. Clear communication about financial responsibility before services, transparency about costs, and compassionate but persistent follow-up […]
Coordination of benefits (COB) determines which insurance pays first (primary) and which pays second (secondary). The birthday rule typically determines order for dependent children, with the parent whose birthday falls earlier in the calendar year being primary. For spouses, each person’s own insurance is usually primary for themselves. Claims must be submitted to the primary […]
Medwave Billing & Credentialing and its educated team of experts have worked with multiple commercial and government insurances. We’ve worked with the following insurers: Aetna AARP Align Network Amerihealth Anthem BCBS Assurant Health CHIP Cigna Consumers Life Insurance Company Coventry One Freedom Blue Geisinger Health Plan Health America Health Net Highmark BCBS Horizon BCBS Humana […]
