Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Call: (412) 219-4789 | Fax: (866) 422-9277
  • Credentialing
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    • 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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  • Claims Management

Claims Management

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 Choose The Right Clearinghouse Services

April 9, 2024 / admin / Articles, CAQH, CAQH CORE Certification, Claim Transmission, Claims Management, Clearinghouse, Clearinghouse Service, EHNAC Accreditation, EHR, EHR Integration, EHR Interoperability, EMR, EMR Integration, HIPAA, HIPAA Compliance, HL7, HL7 Standards
Medical Billing Clearinghouse

Clearinghouses play a crucial role in facilitating the electronic exchange of data between providers, payers, and other entities. Clearinghouses act as intermediaries, converting data from proprietary formats used by different systems into standardized formats that can be understood by all parties involved. With so many clearinghouse options available, selecting the right one can be a […]

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CAQH CORE Certification, clearinghouse, EHNAC Accreditation, EHR, EHR Integration, EMR, EMR integration, HIPAA Compliance, HL7, HL7 interoperability, HL7 Standards, Regulatory Compliance, Value-Added Services

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

How to Take Your Medical Billing to the Next Level in 2024

January 27, 2024 / admin / Articles, Billing, Billing AI, Billing Automation, Billing Best Practice, Billing Revenue, Billing Services, Claims Management, Coding, Denial Codes, Denial Management, Denial Trends, Denied Claims, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing AI, Medical Billing Analytics, ROI

Medical billing is a complex and ever-evolving field. With constant changes in regulations, coding guidelines, reimbursement rates, and technology, medical billing services must continuously adapt and improve to stay competitive. Taking your medical billing to the next level requires focusing on efficiency, optimization, training, and utilizing the latest tools and software. Implementing the strategies outlined […]

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clearinghouse, EDI, healthcare, Healthcare Billing, Medical, Medical Billing, medical billing strategy, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, ROI, RPA

Relieving Medical Billing Frustrations: The Benefits of Outsourcing to Qualified Professionals

December 28, 2023 / admin / Articles, Billing, Billing AI, Billing Automation, Billing RPA, Claim Billing, Claim Denials, Claims Management, Denial Management, Denied Claims, Healthcare, Healthcare Billing, Medical Billing, Medical Billing AI, RCM, Revenue Cycle, Revenue Cycle Management
Outsourcing Medical Billing

Medical billing plays a pivotal yet oft-overlooked role in provider financial stability and continuity of care operations. However, limited resources and inadequate solutions burden in-house teams trying to navigate outdated systems. The resulting claim delays, reimbursement leakage, and patient dissatisfaction has brought many practices to a breaking point. While outsourcing presents risks if not properly […]

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billing, healthcare, Healthcare Billing, Medical, Medical Billing, outsourced billing, outsourced medical billing, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, RPA

Boosting Revenue Integrity: 7 Keys to Unlocking Efficient, Effective Medical Billing

December 18, 2023 / admin / Articles, Billing, Billing Revenue, Claims Management, Denial Management, Healthcare, Healthcare Billing, KPI, Medical Billing, Medical Billing KPIs, RCM, RCM Challenges, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Management (RCM), Revenue Cycle Optimization, Revenue Integrity
Medical Billing White Guy

Amidst an increasingly complex healthcare payer environment, medical billing has direct implications on the financial viability of providers to maintain daily operations and invest in advancing care. However, antiquated systems still relying on manual workflows struggle to effectively navigate critical revenue cycle processes and optimization in the modern digital era. The resulting claims denials, patient […]

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Why Would a Medical Provider Want to Use Robotic Process Automation?

December 13, 2023 / admin / Articles, Artificial Intelligence, Automation, Billing, Billing AI, Billing Automation, Claim Transmission, Claims Management, Healthcare, Healthcare AI, Healthcare Billing, HIPAA, HL7, Medical Billing, Medical Billing Automation, Robotic Process Automation, RPA
Robotic Process Automation (RPA) Medical Billing

Robotic Process Automation (RPA) has transformed industries across the globe by automating repetitive, rules-based digital tasks. In recent years, healthcare providers have begun to realize the immense potential benefits RPA can offer their organizations too. Implementing RPA can be a challenging process, but for those willing to invest in change, the payouts are plentiful. Below, […]

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AI, artificial intelligence, Automation, Billing Automation, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Automation, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, RPA

Evolving Medical Billing Talent Strategies: The Rise of Offshoring and Outsourced Models

November 25, 2023 / admin / Articles, Billing, Billing Automation, Billing Best Practice, Billing Revenue, Billing RPA, Billing Services, Claim Data, Claims Management, Healthcare, Healthcare Billing, HIPAA, HIPAA and Data Protection, HIPAA Compliant, HL7, Medical Billing, Offshore Billing, Outsourced Billing
Offshore Medical Billing

Medical billing involves the complex processes of coding services, generating insurance claims, managing rejection disputes, and ultimately securing optimal reimbursement for healthcare providers. With mounting administrative burdens and revenue pressures facing US healthcare systems, demand has accelerated for skilled medical billing talent. However, tight labor markets have spurred shortages. Below, we analyze the spreading adoption […]

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healthcare, Healthcare Billing, HIPAA, HIPAA Compliant, HL7, Medical, Medical Billing, Offshore Billing, Outsource Medical billing, outsourced billing, outsourced medical billing, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, RPA

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

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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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