Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Call: (412) 219-4789 | Fax: (866) 422-9277
  • Credentialing
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  • Specialties
    • Behavioral Health
    • Toxicology
    • Genetic Testing
    • Pharmacogenetic (PGx) Testing
    • COVID-19 Testing
    • Allergy Testing
    • Skilled Nursing Facilities
    • Urgent Care
    • Oncology
    • Pathology
    • OBGYN
    • Biologics and Specialty Drugs
    • Telestroke and Teleneurology
    • Remote Patient Monitoring
    • Remote Therapeutic Monitoring
    • Home Infusion Therapy
    • Speech Therapy
    • DME
    • Substance Abuse
    • Sleep Study Labs
    • Physical Therapy (PT)
    • Occupational Therapy
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Billing

Tough Questions Providers May Ask Billers

December 1, 2024 / admin / Articles, Billing, Claim Denial Rate, Claim Denials, Compliance, EHR, EMR, Interoperability, Medical Billers, Medical Billing, Medical Billing Questions, Modifiers, Reimbursement, Reimbursement Models, Reimbursement Optimization
Latina Female Medical Provider Owner

The relationship between medical providers and their billing teams has become increasingly crucial to practice success. As reimbursement models grow more complicated and regulatory requirements more stringent, providers often find themselves grappling with challenging questions about their revenue cycle management. We’ll address the most demanding and complex questions that medical providers frequently ask their billing […]

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billing, Claim Denial Rate, Claim Denials, compliance, EHR, EMR, Interoperability, Medical Billers, Medical Billing, medical billing questions, Modifiers, reimbursement, Reimbursement Models, Reimbursement Optimization

Top Motivation Hacks to Keep Medical Billing on Track

November 4, 2024 / admin / Articles, Automated Billing, Automation, Billing, Billing Automation, Billing Challenges, Billing Goals, Billing Outcomes, Coding, Medical Billing, Medical Billing Artificial Intelligence, Medical Billing Automation, Motivation Hacks
Medical Owner White Businessman

Medical billing can feel like a chore. For many providers, it’s not exactly the reason they got into healthcare. But staying on top of billing is essential to running a smooth, profitable practice. Plus, accurate billing means fewer denied claims, less time chasing down payments, and ultimately more focus on what matters most—caring for patients. […]

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automated billing, Automation, billing, Billing Automation, Billing Challenges, Billing Goals, Billing Outcomes, Coding, Medical Billing, Medical Billing Artificial Intelligence, Medical Billing Automation, Motivation Hacks

Claimxiety: When Billing Claims Keep You Up at Night

November 3, 2024 / admin / Articles, Billing, Billing Worries, Claims Management, Claims Management Challenges, Claimxiety, Clean Claim Rate, Medical Billing, Medical Billing Errors, Medical Claim Denials, Medical Claim Rejection, Medical Claims
Claimxiety

Every healthcare provider knows the feeling. It starts with a subtle knot in your stomach as you review the day’s claims submissions. Your mind races through the endless possibilities of what could go wrong: Was the diagnosis code correct? Did we document everything properly? Will this claim be denied… again? Welcome to “Claimxiety” – that […]

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billing, Billing Worries, Claims Management, Claims Management Challenges, Claimxiety, Clean Claim Rate, Medical Billing, Medical Billing Errors, Medical Claim Denials, Medical Claim Rejection, medical claims

How to Set Clear Goals for Medical Billing That Keep Your Practice Profitable

November 2, 2024 / admin / Articles, Billing, Billing Goals, Clean Claim Rate, Medical Billing, Medical Billing Goals, RCM, RCM Optimization, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization
Crazy Medical Coder Biller

Let’s face it – medical billing isn’t exactly the most exciting part of running a healthcare practice. But here’s the thing: those numbers directly impact whether your practice thrives or struggles. Having worked with countless medical practices over the years, I’ve seen firsthand how setting clear, strategic billing goals can transform a practice’s financial health. […]

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billing, Billing Goals, Clean Claim Rate, Medical Billing, Medical Billing Goals, rcm, RCM Optimization, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization

Essential Procedures in Medical Claims Billing

October 25, 2024 / admin / Accurate Coding, Articles, Billing, Billing Denied Claims, Charge Entry, Claim Billing, Claim Denial, Claim Denial Rate, Claim Denials, Denial Management, Denied Claims, Fee Schedule Management, Proper Documentation
Medical Billing Company Principal

If you’ve ever wondered why medical billing seems so complicated, you’re not alone. The process of billing medical claims involves numerous critical procedures that must be followed meticulously to ensure proper reimbursement and compliance. Let’s dive into the most important procedures that can make or break the medical billing process. Patient Information Verification One of […]

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Accurate Coding, Administrative Documentation, Articles, billing, Billing Denied Claims, Charge Entry, Claim Billing, Claim Denial, Claim Denial Rate, Claim Denials, Clinical Documentation, denial management, denied claims, Fee Schedule Management, Proper Documentation

“Medical Billing Near Me”: Service Across Major U.S. Cities

October 22, 2024 / admin / Articles, Billing, Billing Locations, Billing Regions, Credentialing, Medical Billing, Medical Billing Near Me, Medical Billing Service, Medical Credentialing, Revenue Cycle Management
Medical Billing Near Me

When healthcare providers search for “medical billing near me,” they’re looking for reliable, professional services that understand their local healthcare landscape. While we’re based just north of Pittsburgh, PA, where we’ve been serving the community for decades, our expertise extends across the United States, providing specialized medical billing and credentialing services to healthcare providers in […]

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billing, Billing Automation, Billing Best Practice, Billing Case Studies, Billing KPIs, Billing Locations, Billing Process, Credentialing, Medical Billing, Medical Billing AI, Medical Billing Near Me, medical credentialing, Revenue Cycle Management

Efficient Modifier Usage Streamlines Billing Success

October 19, 2024 / admin / Articles, Billing, Billing Codes, Coding, Coding and Billing, Medical Billing, Medical Coder, Medical Coding, Modifier 22, Modifier 25, Modifier 26, Modifier 50, Modifier 51, Modifier 59, Modifier TC
Crazy Medical Coder Biller

Efficient and accurate billing practices are essential for maintaining the financial health of healthcare providers and ensuring proper reimbursement for services rendered. One key element in optimizing medical billing processes is the effective use of modifiers. These two-digit codes provide additional information about medical procedures and services, allowing for more precise billing and reducing the […]

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billing, Billing Codes, Coding, Coding Accuracy, coding and billing, Medical Billing, Medical Coder, medical coding, Medical Coding Accuracy, Modifier, Modifier 22, Modifier 25, Modifier 26, Modifier 50, Modifier 51, Modifier 59, Modifier TC

Revenue Revolution: Transforming Your Billing Practices

October 17, 2024 / admin / Articles, Artificial Intelligence, Automated Billing, Automation, Billing, Data Analytics, Data Integration, Data Interoperability, Interoperability, Manual Billing, Medical Billing
Revenue Cycle Management Coins

The way companies handle their billing processes can make or break their success. As organizations strive to stay competitive and meet evolving customer expectations, transforming billing practices has become a critical imperative. We’ll reveal the intricacies of modern billing systems, highlighting innovative strategies and technologies that can revolutionize your revenue management. The Importance of Effective […]

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artificial intelligence, automated billing, Automation, billing, Billing Challenges, Data Analytics, Data Integration, Data Interoperability, Interoperability, Manual Billing, Medical Billing

What is a Clean Claim Rate?

October 12, 2024 / admin / Articles, Billing, Billing KPIs, CCR, Claim Denial, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Clean Claim Rate, Revenue Cycle, Revenue Cycle Management
electronic-claim-attachments

In healthcare revenue cycle management, few metrics carry as much weight as the Clean Claim Rate (CCR). This crucial key performance indicator (KPI) serves as a fundamental measure of a healthcare organization’s billing efficiency and effectiveness. As healthcare providers face increasing pressure to optimize their revenue cycles while maintaining high-quality patient care, understanding and improving […]

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billing, Billing KPIs, CCR, Claim Denial, claim denial prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Clean Claim Rate, Revenue Cycle, Revenue Cycle Management

Key Mechanisms Used in Behavioral Health Billing

October 1, 2024 / admin / Articles, Behavioral Health, Behavioral Health Billing, Behavioral Health Codes, Behavioral Health CPT Codes, Behavioral Health Integration, Billing, CPT, CPT Codes, CPT Definitions, EDI, Electronic Data Interchange, HIPAA
Key Behavioral Health Billing Mechanisms

Behavioral health billing is a complex and crucial aspect of the healthcare industry, specifically focused on mental health and substance abuse services. It involves intricate processes, numerous codes, and strict regulations to ensure accurate reimbursement for services provided while maintaining patient privacy and data security. We research the various mechanisms used in behavioral health billing, […]

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Behavioral Health, Behavioral Health Billing, Behavioral Health Codes, Behavioral Health CPT Codes, Behavioral Health Integration, billing, CPT, CPT codes, CPT definitions, EDI, Electronic Data Interchange, HIPAA

10 Medical Billing and Coding Certifications to Consider

September 30, 2024 / admin / AAPC, Articles, Billing, Billing Codes, Billing Staff, Coding, Coding Accuracy, Coding and Billing, Coding and Documentation, Coding versus Billing, CPMA, Medical Billing, Medical Billing and Coding, Medical Billing and Coding FAQs, Medical Billing and Coding Salaries, Medical Billing Careers
Medical Billing Coding and Certifications

Medical billing and coding professionals play a crucial role in ensuring accurate record-keeping, proper reimbursement, and smooth operations within healthcare facilities. As the demand for skilled professionals in this field continues to grow, obtaining relevant certifications can significantly enhance your career prospects and earning potential. This blog post explains 10 of the most valuable medical […]

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AAPC, billing, Billing Codes, Billing Staff, Coding, Coding Accuracy, coding and billing, Coding and Documentation, Coding versus Billing, CPMA, Medical Billing, Medical Billing and Coding, Medical Billing and Coding FAQs, Medical Billing and Coding Salaries, Medical Billing Careers

Understanding Urgent Care Billing

September 23, 2024 / admin / Articles, Billing, Medical Billing, Medical Billing and Coding, Urgent Care, Urgent Care Billing, Urgent Care Center, Urgent Care CPT Codes, Urgent Care Diagnosis Codes, Urgent Care Modifiers
Urgent Care CPT Codes

Urgent care centers have become an increasingly popular option for patients seeking immediate medical attention for non-life-threatening conditions. These facilities bridge the gap between primary care physicians and emergency rooms, offering convenient, accessible care without the need for an appointment. However, the billing processes for urgent care services can be complex and often confusing for […]

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billing, Medical Billing, Medical Billing and Coding, Urgent Care, Urgent Care Billing, Urgent Care Center, Urgent Care CPT Codes, Urgent Care Diagnosis Codes, Urgent Care Modifiers

Medical Billing Consulting

September 14, 2024 / admin / Articles, Billing, Billing Case Studies, Billing Consultancy, Billing Consultant, Billing Partnership, Medical Billing, Medical Billing Case Studies, Medical Billing Consultancy, Medical Billing Consulting, Medical Billing Partnership
Medical Billing Consultant

Medical billing stands as a critical component that can make or break a healthcare provider’s financial stability. As regulations become more intricate and reimbursement models shift, many healthcare organizations find themselves struggling to navigate the labyrinth of medical billing. This is where Medwave’s medical billing consulting services step in, offering a beacon of hope and […]

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billing, Billing Case Studies, Billing Consultancy, Billing Consultant, Billing Partnership, Medical Billing, Medical Billing Case Studies, Medical Billing Consultancy, Medical Billing Consulting, Medical Billing Partnership

Medical Coding vs. Medical Billing: Understanding Their Difference

September 13, 2024 / admin / Articles, Billing, Billing Codes, Coding, Coding and Billing, Coding versus Billing, Healthcare Billing, Healthcare Revenue, Medical Billing, Medical Billing and Coding, Medical Coder, Medical Coding
Coding versus Billing

Two crucial roles often cause confusion due to their interconnected nature: medical coding and medical billing. While both are essential components of the healthcare revenue cycle, they involve distinct responsibilities, skill sets, and career paths. We aim to demystify these professions, highlighting their differences, similarities, and importance in the healthcare industry. Introduction to Medical Coding […]

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billing, Billing Codes, Coding, coding and billing, Coding versus Billing, Healthcare Billing, Healthcare Revenue, Medical Billing, Medical Billing and Coding, Medical Coder, medical coding

Navigating Pharmacogenomic Billing

August 3, 2024 / admin / Articles, Billing, Claim Billing, Pharmacogenetics, Pharmacogenetics Billing, Pharmacogenomic Billing, Pharmacogenomic Claims, Pharmacogenomic Codes, Pharmacogenomics
Pharmacogenomic Billing

Pharmacogenomics, the study of how an individual’s genetic makeup influences their response to drugs, has revolutionized the field of medicine. This cutting-edge approach allows healthcare providers to tailor drug therapies to a patient’s unique genetic profile, potentially improving treatment efficacy and reducing adverse reactions. However, as with many innovative medical technologies, the billing and reimbursement […]

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billing, Claim Billing, Pharmacogenetics, Pharmacogenetics Billing, Pharmacogenomic Billing, Pharmacogenomic Claims, Pharmacogenomic Codes, Pharmacogenomics

Emerging Medical Billing Trends in 2025

August 2, 2024 / admin / AI, Articles, Artificial Intelligence, Automated Billing, Automation, Billing, Billing Automation, Blockchain, Blockchain in Healthcare, Blockchain Technology, Cybersecurity, Data Interoperability, FHIR, Health Level 7, HL7, Machine Learning
Medical Biller Techie

The landscape of medical billing is undergoing a rapid transformation as we approach 2025. Driven by technological advancements, changing patient expectations, and evolving healthcare delivery models, the traditional approaches to medical billing are being revolutionized. We aim to explore the emerging trends that are reshaping the medical billing industry, offering insights into how healthcare providers, […]

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Accountable Care Organizations (ACOs), AI, artificial intelligence, automated billing, Automation, billing, Billing Automation, Blockchain, Blockchain in Healthcare, Blockchain Technology, Cybersecurity, Data Interoperability, FHIR, Health Level 7, HL7, Machine Learning

Automation Disintegrates Human Error in Medical Billing

June 14, 2024 / admin / Articles, Automated Billing, Automation, Billing, Billing Automation, Billing RPA, Healthcare Billing, Medical Billing, Medical Billing Automation, Medical Billing Robotic Process Automation, Medical Billing RPA, Robotic Process Automation, RPA
Robotic Process Automation (RPA) Medical Billing

Medical billing automation is probably not going to win any awards for being a riveting conversation topic. It’s one of those mundane but necessary evils that come with running a healthcare organization. I get it – discussing billing processes and paperwork isn’t exactly a thrilling way to spend your time. But hear me out, because […]

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automated billing, Automation, billing, Billing Automation, Billing RPA, Healthcare Billing, Medical Billing, Medical Billing Automation, Medical Billing Robotic Process Automation, Medical Billing RPA, Robotic Process Automation, RPA

10 Tips to Optimize Medical Billing for Maximized Collections

June 2, 2024 / admin / Articles, Billing, Billing KPIs, Billing Outcomes, Billing Software, Billing Staff, Billing Technologies, Healthcare Billing, Medical Billing, Outsource Medical Billing, Outsourced Billing
Medical Billing Tips

Medical billing can be a massive headache. Between keeping up with ever-changing regulations, dealing with rejected claims, and chasing down payments, it’s enough to make anyone’s head spin. But here’s the thing – optimizing your medical billing process is crucial for maximizing collections and keeping your practice financially healthy. Think about it this way: every […]

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billing, Billing KPIs, Billing Outcomes, Billing Software, Billing Staff, Billing Technologies, Healthcare Billing, Medical Billing, Outsource Medical billing

Navigating the Complexities of Behavioral Health Billing

May 31, 2024 / admin / Articles, Behavioral Health, Behavioral Health Billing, Billing, Billing Best Practice, Billing Challenges, Billing Codes, Coding, Coding and Billing, Modifier Codes, Modifiers, Pre-Authorization, Preauthorization
Behavioral Health Billing

Let’s be real, billing and claims processing is probably not what got you into the behavioral health field in the first place. You were driven by a passion to help people overcome mental health challenges, develop positive coping strategies, and improve their overall well-being. But as much as we might wish it were different, managing […]

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Behavioral Health, Behavioral Health Billing, billing, Billing Best Practice, Billing Challenges, Billing Codes, Coding, coding and billing, Modifier Codes, Modifiers, Pre-Authorization, Preauthorization

10 Reasons to Outsource Your Medical Billing

May 7, 2024 / admin / Articles, Billing, Billing Services, Healthcare Billing, HIPAA, HIPAA Compliant, Medical Billing, Medical Billing and Coding, Medical Billing Services, Medical Billing Tips, Outsourced Billing, Outsourced Medical Billing, Outsourcing Medical Billing
Electronic Medical Biller

Whether you’re a physician, practice manager, or anyone else charged with overseeing the billing operations for a healthcare organization, let me start by saying – I feel your pain. Medical billing has always been one of the most maddeningly complex, persistently stressful parts of running a modern medical practice. In today’s healthcare landscape, it just […]

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billing, billing services, Healthcare Billing, HIPAA, HIPAA Compliant, Medical Billing, Medical Billing and Coding, medical billing services, Medical Billing Tips, outsourced billing, outsourced medical billing, Outsourcing Medical Billing

What’s the Difference Between Institutional and Professional Billing?

May 5, 2024 / admin / Articles, Billing, CPT Codes, HCFA-1500, Healthcare Billing, ICD Codes, Institutional Billing, Medical Billing, Medical Billing Lingo, Medical Billing Verbiage, Professional Billing, UB-04, UB-04 Billing
Medical Billing Resources

If you’ve ever stepped foot in a medical facility or had any kind of healthcare service, you’ve likely encountered the wonderful world of medical billing. But have you ever stopped to think about the different billing methods used? Specifically, the distinction between institutional billing and professional billing? No? Well, buckle up because we’re about to […]

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billing, CPT codes, HCFA-1500, HCPCS Codes, Healthcare Billing, ICD Codes, Institutional Billing, Medical Billing, Medical Billing Lingo, Medical Billing Verbiage, Professional Billing, UB-04, UB-04 Billing

What to Expect When Outsourcing Medical Billing

April 17, 2024 / admin / Articles, Billing, Billing AI, Billing Analytics, Billing KPIs, Billing Revenue, Billing RPA, Medical Billing, Medical Billing AI, Outsourced Billing, Outsourced Medical Billing, Outsourcing
Medical Doctors Discussing Billing

If you’re a healthcare provider, dealing with medical billing is probably one of your least favorite parts of the job. It’s tedious, complicated, and takes you away from your real passion – caring for patients. That’s why many practices choose to outsource their medical billing to third-party companies that specialize in it. But what does […]

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billing, Billing AI, Billing Analytics, Billing KPIs, billing revenue, Billing RPA, Medical Billing, Medical Billing AI, outsourced billing, outsourced medical billing, Outsourcing, Revenue Cycle Management

Mastering Charge Capture: A Roadmap for Healthcare Providers

April 13, 2024 / admin / Articles, Automation, Billing, Billing Automation, Charge Capture, Charge Capture Challenges, Charge Capture Strategy, Coding, Coding and Billing, Denials, EHR, EMR, Missed Charges, Optimized Charge Capture, Revenue Leakage
Charge Master Work

If you’re a healthcare provider, you know how important it is to get paid accurately and on time for the services you provide. But the revenue cycle management process can be a tangled web of codes, documentation requirements, and insurance rules. One of the biggest pain points? Charge capture. Charge capture is the process of […]

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billing, Charge Capture, Charge Capture Challenges, Charge Capture Strategy, Denials, EHR, EMR, Medical Billing, Missed Charges, Optimized Charge Capture, Revenue Cycle Management, Revenue Leakage

How Does Medicare Reimbursement Work for Toxicology Testing?

April 5, 2024 / admin / Articles, Billing, Billing Services, GC/MS, LC/MS, Toxicology Billing, Toxicology Lab Billing, Toxicology Labs, Toxicology Medicare Reimbursement, Toxicology Reimbursement Denial, Toxicology Testing, Toxicology Tests
Toxicology Test Reimbursement

Let’s talk about getting reimbursed by Medicare for toxicology tests – those tests that check for drugs or other harmful substances in someone’s body. It can be a confusing process with lots of rules and hoops to jump through. I’m going to break it down simply so you know what to expect. Understanding Medicare Coverage […]

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Advanced Beneficiary Notice, G0480, G0481, G0482, G0659, G0660, GC/MS, LC/MS, Medicare Coverage for Toxicology Tests, Medicare Reimbursement, toxicology billing, Toxicology Medicare, Toxicology Medicare Reimbursement, Toxicology Reimbursement Denial, Toxicology Testing, Toxicology Tests

Which CPT Codes are Used in Remote Patient Monitoring Billing?

March 30, 2024 / admin / Articles, Biling Codes, Billing, Remote Diagnostics, Remote Patient Monitoring, Remote Patient Monitoring (RPM), Remote Patient Monitoring Billing, Remote Patient Monitoring CPT Codes, RPM, RPM Billing, RPM CPT Codes
CPT Codes Remote Patient Monitoring (RPM)

If you’re a healthcare provider looking to get into remote patient monitoring (RPM), one of the first things you need to understand is how to bill for these services. And that starts with knowing the right CPT codes to use. RPM has been around for a while, but it really took off during the COVID-19 […]

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99091, 99453, 99454, 99457, 99473, 99474, billing, CPT codes, Healthcare Billing, Medical Billing, rcm, Remote Patient Monitoring, Remote Patient Monitoring Billing, Remote Patient Monitoring CPT Codes, Revenue Cycle Management, RPM, RPM Billing, RPM CPT Codes
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Practices Served

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

Practices Served

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

Recent Posts

  • Medical Credentialing Staff at a Hospital

    25 Stats Medical Credentialers Must Know

  • Older Female Doctor in need of Credentialing

    Credentialing Problems? We Can Fix Them!

  • Medical Credentialing State-by-State

    Multi-State Licensing in Provider Credentialing

  • Telehealth Provider

    Solutions for Telehealth Credentialing Challenges

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