Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Credentialing and Contracting

Use Case: Behavioral Health Credentialing

October 31, 2025 / admin / Articles, Behavioral Health, Behavioral Health Credentialing, Credentialing, Credentialing and Contracting, Credentialing Applications, Credentialing Challenges, Credentialing Management, Credentialing On-Boarding
Aging Asian-American Female Medical Doctor

Getting credentialed with insurance companies can feel like trying to solve a puzzle where someone keeps hiding the pieces. For behavioral health providers, this challenge becomes even more difficult when you’re trying to credential multiple practitioners across different specialties and license types. This is the story of how a large behavioral health group in the […]

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Behavioral Health, Behavioral Health Credentialing, Credentialing, Credentialing and Contracting, Credentialing Applications, credentialing challenges, Credentialing Management, credentialing on-boarding

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

What Comes First: Credentialing or Contracting?

September 18, 2025 / admin / Articles, Contract Negotiation, Contracting, Credentialing, Credentialing and Contracting, Credentialing Challenges, Credentialing Documentation, Credentialing Software, Credentialing Technology, Payer Contracting
Twin White Male Medical Doctors Looking at Each Other

Healthcare providers entering the world of insurance partnerships face a chicken-and-egg dilemma that can make even seasoned professionals scratch their heads. Should you get credentialed first, or should you secure contracts before diving into the credentialing process? The answer isn’t as straightforward as you might think, and knowing the nuances can save you months of […]

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Contract Negotiation, Contracting, Credentialing, Credentialing and Contracting, credentialing challenges, Credentialing Documentation, Credentialing Software, Credentialing Technology, Payer Contracting

25 Stats Medical Credentialers Must Know

May 24, 2025 / admin / Articles, Credentialing, Credentialing Accuracy, Credentialing and Contracting, Credentialing Applications, Credentialing Challenges, Credentialing Compliance, Credentialing KPIs, Credentialing Metrics, Credentialing Stats
Medical Credentialing Staff at a Hospital

Medical credentialing professionals play a critical role in ensuring patient safety and quality care. Verifying the qualifications, experience, and background of healthcare providers allows credentialers serve as essential gatekeepers for the entire healthcare system. With the industry rapidly evolving through technological advancements, regulatory changes, and shifting workforce dynamics, staying informed is more important than ever. […]

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Credentialing, Credentialing Accuracy, Credentialing and Contracting, Credentialing Applications, credentialing challenges, Credentialing Compliance, Credentialing KPIs, Credentialing Metrics, Credentialing Stats

Want to Start a Medical Credentialing Company?

April 4, 2025 / admin / Articles, Credentialing, Credentialing and Contracting, Credentialing Company, Credentialing Jobs, Credentialing Manager, Credentialing Process, Credentialing Specialist, Credentialing Tips, Medical Credentialing Company
Credentialing Expert Hispanic Male

Medical credentialing has become an essential service that bridges the gap between healthcare providers and insurance companies. If you’re considering starting a medical credentialing company, you’re looking at an industry with steady demand and significant growth potential. Why Start a Medical Credentialing Company? Healthcare is a massive industry with no signs of slowing down. As […]

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Credentialing, Credentialing and Contracting, Credentialing Company, Credentialing Jobs, Credentialing Manager, credentialing process, Credentialing Specialist, Credentialing Tips, Medical Credentialing Company

Automation in Medical Credentialing

December 16, 2024 / admin / Articles, Automated Credentialing, Automation, Credentialing, Credentialing Accuracy, Credentialing AI, Credentialing and Contracting, Credentialing Automation, Credentialing Challenges, Credentialing Delays, Credentialing Difficulty, Medical Credentialing Automation
Asian Indian Woman Credentialing

Let’s dive into a topic that’s transforming healthcare behind the scenes: medical credentialing automation. If you’ve ever wondered how healthcare organizations manage the complicated process of verifying medical professionals’ qualifications, you’re in for an eye-opening journey. What is Medical Credentialing? First things first, let’s break down what medical credentialing actually means. Imagine you’re a patient […]

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Automated Credentialing, Automation, Credentialing, Credentialing Accuracy, Credentialing AI, Credentialing and Contracting, Credentialing Automation, credentialing challenges, Credentialing Delays, Credentialing Difficulty, Medical Credentialing Automation

A Guide to Provider Credentialing with Aetna

October 10, 2024 / admin / Aetna, Aetna Credentialing, Articles, Credentialing, Credentialing AI, Credentialing and Contracting, Credentialing New Providers, Credentialing On-Boarding, Credentialing with Aetna, Medical Credentialing, Recredentialing
Guide to Provider Credentialing with Aetna

Provider credentialing is a critical process in the healthcare industry that ensures medical professionals meet specific standards of education, training, and experience before they can join an insurance network. We inspect the intricacies of credentialing with Aetna, one of the largest health insurance providers in the United States, offering valuable insights for healthcare providers seeking […]

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Aetna, Aetna Credentialing, Credentialing, Credentialing AI, Credentialing and Contracting, Credentialing New Providers, credentialing on-boarding, Credentialing with Aetna, Healthcare, Medical Credentialing, Revenue Cycle Management

How Long Does Medical Credentialing Take?

October 9, 2024 / admin / Articles, CAQH, Credentialing, Credentialing Accuracy, Credentialing and Contracting, Credentialing Difficulty, Credentialing On-Boarding, Credentials Verification Organizations, CVO
Medical Credentialing Woman

Medical credentialing is a crucial but often time-consuming process that healthcare providers must undergo to verify their qualifications and ensure patient safety. We explore the various factors that influence credentialing timelines, typical durations, and strategies to expedite the process. Understanding Medical Credentialing Medical credentialing is the systematic process of verifying the qualifications of healthcare providers, […]

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CAQH, Credentialing, Credentialing Accuracy, Credentialing and Contracting, Credentialing Difficulty, credentialing on-boarding, Credentials Verification Organizations, CVO

Credentialing is Difficult; Outsource It

April 21, 2024 / admin / Articles, Credentialing, Credentialing Accuracy, Credentialing AI, Credentialing and Contracting, Credentialing New Providers, Credentialing On-Boarding, Medical Credentialing, Medical Credentialing AI
White Female Credentialing Professional

If you’re in the healthcare industry or deal with professionals who need to be credentialed, you know how complex and time-consuming the whole process can be. From verifying licenses and certifications to checking work histories and malpractice claims, credentialing is a massive headache that never seems to end. But here’s the thing, you don’t have […]

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Credentialing, Credentialing Accuracy, Credentialing AI, Credentialing and Contracting, Credentialing New Providers, credentialing on-boarding, Medical Credentialing, Medical Credentialing AI, RCM, Revenue Cycle, Revenue Cycle Management

The Importance of Credentialing and Contracting

February 21, 2023 / admin / Articles, Contracting, Credentialing, Credentialing and Contracting, Medical Credentialing, Payer Contract, Payer Contracting, Payer Enrollment, Payer Negotiation, Payer Rejection
White Female Credentialing Professional

Credentialing and contracting are essential components of healthcare operations. Credentialing is the process of verifying the qualifications and professional background of healthcare providers, while contracting involves establishing agreements between healthcare providers and payers to ensure payment for services rendered. These processes are crucial for ensuring that healthcare providers deliver high-quality services and receive fair compensation […]

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Contracting, Credentialing, Credentialing and Contracting, Credentialing and Contracting Checklist, Healthcare Credentialing, Medical Credentialing, Payer Contract, Payer Contracting

Recent Posts

  • Primary Care Medical Billing, Credentialing

    Which CPT Codes are Used in Primary Care Billing

  • A Group of Contracted Doctors Standing in Times Square

    Provider Challenges in Payer Contracting

  • White Female Master Medical Credentialing Expert

    Complete Credentialing and Enrollment Process for Providers

  • Aging Asian-American Female Medical Doctor

    Use Case: Behavioral Health Credentialing

  • AI Bot Assistance in Medical Credentialing

    How Does AI Assist Medical Credentialing?

  • Medical Credentialing Specialist Resume

    How to Write a Medical Credentialing Specialist Resume

Practices Served

  • Behavioral Health
  • Primary Care
  • 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
  • Podiatry
  • 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
  • Primary Care
  • 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
  • Podiatry
  • 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

  • Primary Care Medical Billing, Credentialing

    Which CPT Codes are Used in Primary Care Billing

  • A Group of Contracted Doctors Standing in Times Square

    Provider Challenges in Payer Contracting

  • White Female Master Medical Credentialing Expert

    Complete Credentialing and Enrollment Process for Providers

  • Aging Asian-American Female Medical Doctor

    Use Case: Behavioral Health Credentialing

  • AI Bot Assistance in Medical Credentialing

    How Does AI Assist Medical Credentialing?

  • Medical Credentialing Specialist Resume

    How to Write a Medical Credentialing Specialist Resume

  • AI Black Male Medical Doctor Touches Robot Finger

    AI’s Ethical Frontier: Managing Healthcare’s Data Morality

  • FHIR Data Exchange Interoperability

    FHIR® Interoperability: The Hidden RCM Benefit of Real-Time Data Exchange

  • Anthem BCBS Credentialing, Recredentialing, and Contracting

    A Guide to Provider Credentialing with Anthem

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