Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Call: (412) 219-4789 | Fax: (866) 422-9277
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    • Allergy Testing
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    • Oncology
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    • Remote Therapeutic Monitoring
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  • Claim Rejection

Claim Rejection

This Halloween, Scare Away the Denied Claims!

October 24, 2024 / admin / Articles, Claim Denial, Claim Denials, Claim Rejection, Denial Analytics, Denial Codes, Denial Management, Denial Prevention Strategy, Denials, Denials Managements, Denied Claims, Denied Medical Claims, Halloween
Halloween: Scary Denial Claims

🎃 BOO! Did that denied claim just give you a fright? Don’t worry – we’re here to help you turn those scary denials into sweet success. Just like preparing for trick-or-treaters, a little preparation goes a long way in the world of medical billing. Let’s unmask the spooky specters of denied claims and learn how […]

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Claim Denial, Claim Denials, Claim Rejection, Denial Analytics, Denial Codes, denial management, Denial Prevention Strategy, Denials, Denials Managements, denied claims, denied medical claims, Halloween

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

Claim Denial vs. Rejection: What’s the Difference?

February 23, 2024 / admin / Articles, Claim Denial, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Claims Management, Clearinghouse Rejection, Denial Management, Denial Prevention Strategy, Denial Trends, Denial vs Rejection, Denied Claims, Denied Medical Claims, Payer Rejection, Rejected Claims
Medical Claim Denied Doctor

In the healthcare industry, there are two main ways that insurance companies respond when they decide not to pay a claim – denial and rejection. Both indicate the claim will not be paid, but there are some important differences between the two. Understanding the distinction is critical for medical providers to correctly follow-up so they […]

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Claim Denial, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Clearinghouse Rejection, Denial vs Rejection, denied claims, healthcare, Healthcare Billing, Medical, Medical Billing, Payer Rejection, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization

Strategies for Dealing with Denied Claims

February 21, 2024 / admin / Articles, Billing, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Denial Analytics, Denial Codes, Denial Management, Denial Prevention Strategy, Denial Trends, Denials Managements, Denied Claims, Denied Medical Claims

Dealing with denied claims is one of the most frustrating and time-consuming aspects of medical billing. However, there are several strategies billing staff can employ to efficiently handle denials, appeal them successfully, and prevent denials from occurring in the first place. We analyze the most effective ways to deal with denied claims in medical billing. […]

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billing, claim denial manager, Claim Denials, Claim Rejection, Claim Rejection Rate, denial management, Denial Prevention, Denial Prevention Strategy, Denial Trends, Denials, denied claims, Healthcare Billing, Medical Billing, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization

Top Strategies to Drastically Reduce Claim Denial Rates in 2024

February 5, 2024 / admin / Appeals Management, Articles, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Denial Management, Denial Trends, Denied Claims, Denied Medical Claims, Medical Necessity, Patient Insurance Eligibility, Pre-certifications, Preventable Denial Rates, Reducing Denials
Medical Claim Denied Doctor

Claim denials continue to be a persistent challenge for healthcare providers in 2024. The costly administrative burden of denied claims and appeals, coupled with lower revenues and margins, puts increasing pressure on organizations to find ways to prevent denials and increase collections. The good news is there are proven strategies providers can implement to proactively […]

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Appeals management, Authorizations, claim denial prevention, denial rates, documentation, medical necessity, patient demographic/insurance data, patient insurance eligibility, Pre-certifications, preventable denial rates, Reducing Denials, verification

Decoding Medical Claims: an Introductory 101 Guide

November 22, 2023 / admin / Articles, Billing, Charge Capture, Claim Billing, Claim Data, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Claim Status, Claim Transmission, Claims Management, Coding, First Pass Rate, High Claim Volumes, Patient Dissatisfaction, Provider Dissatisfaction, Regulatory Exposure, Suboptimal Claims
White Female Medical Billing Outsourced

Navigating insurance claims represents one of the most vital yet complex aspects of running a successful medical practice. Claim submission impacts cash flow, revenue realization, and provider satisfaction. For staff new to healthcare administration, the terminology and processes around medical claims can seem confusing. We analyze the fundamentals in simple terms – from types of […]

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Charge Capture, Claim Denial Rate, Claim Rejection Rate, Claim Transmission, Claims Lifecycle Management, Claims Management Challenges, First Pass Rate, High Claim Volumes, Patient Dissatisfaction, Provider Dissatisfaction, Regulatory Exposure, Suboptimal Claims

Growing Risk of Claim Denials: How to Protect Your Practice

October 6, 2023 / admin / Articles, Billing, Billing Denied Claims, Claim Denials, Claim Rejection, Claim Status, Claim Status Updates, Denial Codes, Denial Management, Denial Prevention Strategy, Denial Trends, Denied Claims, Denied Medical Claims, RCM, RCM Challenges, Revenue, Revenue Cycle Management, Revenue Integrity, Revenue Leakage
Medical Claim Denied

For medical practices, claim denials have always been a fact of life when dealing with health insurers. However, trends show claim denial rates growing year over year, driven by increased utilization management efforts by payers. Denials directly impact practice revenues and the time/costs tied to appealing denials. Below, we take a gander at the factors […]

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Claim Denials, Denial Codes, Denial Prevention Strategy, Denial Trends, Denials, denied medical claims, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, Revenue Cycle Management, revenue cycle optimization

Must-have Metrics for Measuring Medical Billing Success

September 27, 2023 / admin / Articles, Billing, Billing Revenue, Billing Services, Claim Data, Claim Denials, Claim Rejection, Coding, CPT Code, Healthcare, Healthcare Billing, Healthcare KPIs, Healthcare Outcomes, Healthcare Revenue, Medical Billing, Medical Billing AI, Medical Billing Analytics, Medical Billing Service, Revenue Cycle Management
White Female Medical Billing Outsourced

Medical billing is a complex, numbers-driven process. To elevate revenues and efficiency, healthcare practices must constantly measure, analyze and optimize their medical billing and revenue cycle performance using key metrics. The Importance of Analytics in Medical Billing In the dynamic healthcare landscape, data is king. Medical practices that succeed at leveraging data make better decisions […]

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CPT Code, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Analytics, Medical Billing Service, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation

Why Outsource Your Medical Billing?

June 26, 2023 / admin / Articles, Billing, Billing Automation, Billing Best Practice, Billing Revenue, Billing Services, Claim Billing, Claim Denials, Claim Rejection, Commonly Asked Medical Billing Questions, FAQs, Full Service Medical Billing, Healthcare, Healthcare Billing, HIPAA, HIPAA Compliant, Medical, Medical Billing
White Female Medical Billing Outsourced

In today’s fast-paced healthcare industry, medical billing plays a crucial role in the financial stability and success of medical practices. However, managing the complexities of medical billing can be overwhelming for healthcare providers. This is where outsourcing your medical billing can be a game-changer. In this article, we will explore the reasons why outsourcing your […]

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healthcare, Healthcare Billing, Medical Billing, Medical Billing Service, medical billing strategy, medical claims, Outsource Medical billing, outsourced billing, outsourced medical billing, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization

Denial Codes in Medical Billing: A Comprehensive Guide

May 21, 2023 / admin / Articles, Billing, Billing Best Practice, Billing Services, Claim Billing, Claim Denials, Claim Rejection, Claim Status, Denial Codes, Denials Managements, Denied Claims, Denied Medical Claims, Rejected Claims
Rejected, Denied Medical Claim

Welcome to our comprehensive guide on denial codes in medical billing. As a leading authority in the healthcare industry, we understand the challenges healthcare providers face when it comes to navigating the complex world of medical billing. Our goal is to provide you with valuable insights and actionable strategies to help you overcome denial code challenges […]

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Denial Codes, denial management, denied medical claims, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, outsourced billing, Revenue Cycle Management, revenue cycle optimization

The Benefits of Using a Medical Billing Company for Healthcare Providers

February 1, 2023 / admin / Articles, Claim Billing, Claim Denials, Claim Rejection, Healthcare, Healthcare Billing, HIPAA, HIPAA Compliant, Medical Billing, Medical Billing Companies
White Female Medical Billing Outsourced

The Value of Using an Outsourced Medical Billing Company The Complex Nature of Medical Billing Healthcare providers are faced with a growing number of challenges when it comes to managing their medical billing operations. With the complex nature of healthcare billing, the increasing regulations and laws that govern the industry, and the need to stay […]

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billling, healthcare, Healthcare Billing, Medical Billing, Medical Billing Company, Outsource Medical billing, outsourced billing, Revenue Cycle Management

The Crucial Role of Medical Billing in Healthcare

February 1, 2023 / admin / Articles, Billing, Billing Denied Claims, Billing Revenue, Claim Billing, Claim Denials, Claim Rejection, Denied Claims, Denied Medical Claims, EHR, EHR Integration, EMR, EMR Integration, Full Service Medical Billing, Healthcare, Healthcare Billing, HIPAA, Medical, Medical Billing, Medical Billing Companies, Robotic Process Automation, RPA
electronic-claim-attachments

Medical Billing: Basics, Role of Specialists, Challenges, RPA and What to Look for in a Company Medical billing is an important aspect of the healthcare industry that plays a crucial role in ensuring that patients receive the medical treatment they need while healthcare providers are reimbursed for the services they offer. The process involves submitting […]

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Billing Accuracy, HIPAA, HIPAA Compliant, Medical Billing, Medical Billing Compliance, Medical Billing Customer Service, Medical Billing Expertise, Medical Billing Robotic Process Automation, reimbursement rates, Robotic Process Automation, RPA

Struggling with Claim Denials?

December 28, 2022 / admin / Articles, Billing, Billing Denied Claims, Claim Billing, Claim Denials, Claim Rejection, Denials Managements, Denied Claims, Denied Medical Claims, Medical Billing, Medical Claim Denials, Medical Claim Rejection, Medical Claims, Medical Payor

Overcome Claim Denials Claim Denials are Challenges for Healthcare Providers Even healthcare providers who deploy safeguards to dodge insurance payment hazards, occasionally find themselves up against a claim denial. Taking care of denied insurance claims can be a frustrating process for healthcare practitioners and their office staff. That’s why it’s vital to utilize a claim […]

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billing, Claim Denial, Claim Denials, Claim Rejections, denial management, denied medical claim prevention, denied medical claims, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Claim Rejections, medical claims, Medical Payor, rcm, Revenue Cycle Management

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  • OBGYN
  • Biologics and Specialty Drugs
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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

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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