Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Contract Management

Why Providers Need Both Credentialing and Contracting

October 1, 2025 / admin / Articles, Contract Management, Contract Negotiation, Contracting, Credentialing, Credentialing and Contracting, Medical Credentialing, Payer Contract, Payer Contract Management, Payer Contracting, Payor Contract, Payor Contracting
A White, Male Medical Doctor Signing Paperwork. Sitting at a desk.

Healthcare providers often view credentialing and contracting as separate administrative hurdles they must clear to start practicing. While these processes might seem distinct on the surface, they’re actually two sides of the same coin, both essential components of establishing a viable healthcare practice. Knowing why both are necessary, and how they work together, can save […]

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Contract Management, Contract Negotiation, Contracting, Credentialing, Credentialing and Contracting, Medical Credentialing, Payer Contract, Payer Contracting, Payor Contract, Payor Contracting

How to Restructure Payer Contracts

August 31, 2025 / admin / Articles, Contract Management, Payer Contract, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Payer Regulations, Payor Contract, Payor Contracting
Agreement to Negotiate Contracts in Healthcare

Healthcare providers often believe they have limited options when it comes to improving their payer contracting income. This assumption couldn’t be further from the truth. Contract negotiation and contract management represent powerful tools your healthcare organization can leverage to enhance current contracts and increase revenue substantially. The challenge lies in execution. Many physicians struggle to […]

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Payer Contract, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Payer Regulations, Payor Contract, Payor Contracting

Key Performance Indicators That Drive Payer Contract Decisions

January 31, 2025 / admin / Articles, Contract Management, Payer Contract, Payer Contract Negotiation, Payer Contracting, Payer Contracts, Payer Negotiation, Payer Regulations, Payor Contract, Payor Contracting
Group of diverse medical doctors in scrubs, smiling

Healthcare payers operate in a data-rich environment where every contract decision can impact millions of dollars in claims, member satisfaction, and regulatory compliance. The metrics that guide these decisions go far beyond simple cost considerations, encompassing quality outcomes, network adequacy, and member experience factors that directly influence an organization’s competitive position and financial health. Smart […]

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Contract Management, Payer Contract, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Payer Regulations, Payor Contract, Payor Contracting

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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
  • Primary Care
  • 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

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
  • Primary Care
  • 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

Recent Posts

  • Bridge Gap Healthcare Business

    Bridging the Credentialing Gap Between Payer & Provider Organizations

  • CareSource Credentialing

    A Guide to Provider Credentialing with CareSource

  • Middle-Aged White Male Medical Doctor

    Credentialing Denials: The Ugly Truth

  • Behavioral Health Credentialing, Billing & Contracting Use Case

    Use Case: Behavioral Health Contracting

  • Group of Medical Doctors Discussing Charge Capture at Hospital

    10 Billing KPIs Every Healthcare Provider Should Know

  • Tax Status Dictates Contract Structure (Doctor Signing)

    Tax Status Dictates Contract Structure

  • Blonde Female Healthcare Provider / Owner

    New NCQA 2025 Rules and Their Impact

  • Black Male and Female Medical Doctors

    Payer Contracting: Unlock Your Revenue Potential

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