Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Call: (412) 219-4789 | Fax: (866) 422-9277
  • Credentialing
  • Payer Contracting
  • Medical Billing
  • 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
  • HL7 Integration
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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 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

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

10 Key Medical Billing Challenges and Solutions

March 5, 2024 / admin / A/R, A/R Recovery, Articles, COB, Coding Accuracy, Healthcare KPIs, Healthcare Outcomes, HIPAA, HIPAA Compliance, Patient Eligibility, Patient Insurance Eligibility, Payer Contracting, RCM, RCM Challenges, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Process, Timely Claim Submission
White Female Medical Billing Outsourced

The medical billing process is a complex and often daunting task for healthcare providers. From keeping up with ever-changing regulations and coding updates to managing denials and claim rejections, medical billers face numerous challenges that can significantly impact revenue cycle management and the financial health of a practice. We cover 10 key medical billing challenges […]

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A/R, A/R Management, Benefits Verification, COB, Coding Accuracy, denial management, HIPAA, HIPAA Compliance, Patient Eligibility, Payer Contracting, Revenue Cycle Management, Revenue Cycle Process, revenue optimization, Timely Claim Submission

How AI is Transforming Healthcare: 12 Real-World Use Cases

January 3, 2024 / admin / AI, AI Diagnostic Models, AI Models, AI Use Cases, Articles, Artificial Intelligence, Data Management, Healthcare, Healthcare AI, Healthcare Use Cases, HIPAA, KPIs, Medical, Medical Use Cases, Patient Care, Use Case
White Female Doctor Healthcare Clinic

Artificial intelligence has moved from hype to mainstream adoption across healthcare, unlocking new possibilities for improving patient outcomes, experiences, and access to care. Below, we’ll explore 12 impactful real-world use cases showing exactly how healthcare providers are leveraging different AI models to enhance clinical workflows, augment decision making, streamline operational processes, and advance precision medicine. […]

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AI, AI Diagnostic Models, AI Models, artificial intelligence, Data Management, healthcare, Healthcare AI, Healthcare Use Cases, HIPAA, KPIs, Medical, Medical Use Cases, Patient Care, Use Case

The Secret Sauce: Essential Ingredients for Optimized Medical Billing Outcomes

December 27, 2023 / admin / Articles, Biling Codes, Billing, Billing AI, Billing Automation, Billing Best Practice, Healthcare Billing, HIPAA, Medical Billing, Medical Billing Ingredients, RCM, Reimbursement, Revenue Cycle Management, Robotic Process Automation, RPA, Secret Sauce
Secret Sauce of Medical Billing

Medical billing sits at the heart of provider revenue cycles, yet few fully appreciate the complexities billing teams navigate to keep financial flows stable. Between interpreting endless payer policies, wrestling with outdated technology, and managing behind-the-scenes patient communications, it takes specialized skills to turn charges into reimbursements. It serves as the financial backbone of the […]

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Healthcare Billing, Healthcare Outcomes, Medical, Medical Billing, Medical Billing Ingredients, Medical Billing Service, Outcomes, outsourced billing, outsourced medical billing, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, RPA, Secret Sauce

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

Why Medwave is the Best Medical Billing Company for Your Practice

August 22, 2023 / admin / Articles, Automation, Billing, Billing AI, Billing Automation, Billing Best Practice, Billing Revenue, Billing Services, Denial Management, HIPAA, Medical Billing, Revenue Cycle Management, Robotic Process Automation, RPA
Accounts Receivable (AR) Recovery

Selecting the right medical billing company is key to ensuring smooth claim processing, optimal reimbursement, and an improved bottom line. As the healthcare revenue cycle becomes more complex, outsourcing to specialists is an increasingly attractive option. Below, we’ll explore why Medwave rises above the rest as the top medical billing service for providers. Deep Medical […]

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healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, medical billing strategy, medical credentialing, Outsource Medical billing, outsourced billing, outsourced medical billing, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, RPA

The Importance of Robotic Process Automation in Medical Billing

June 26, 2023 / admin / Articles, Automation, Billing, Billing Automation, Billing Best Practice, Billing Revenue, Billing RPA, Billing Services, Healthcare, HIPAA, HIPAA Compliant, HL7, Medical, Medical Billing, Medical Billing AI, Medical Billing Automation, Robotic Process Automation, RPA
robotic-process-automation-RPA-example-code

In today’s fast-paced world, the healthcare industry faces numerous challenges when it comes to managing medical billing processes efficiently. With the increasing complexity of healthcare systems and the constant changes in regulations, there is a growing need for automation to streamline and optimize medical billing operations. Robotic Process Automation (RPA) has emerged as a game-changing […]

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healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Robotic Process Automation, Medical Billing Service, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, Robotic Process Automation Billing, Robotic Process Automation Medical Billing, RPA

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

The Future of Medical Billing: Revolutionizing Healthcare Administration

June 7, 2023 / admin / Articles, Artificial Intelligence, Automation, Billing, Billing Services, Blockchain Technology, Coding, CPT Codes, Denial Management, Healthcare, HIPAA, HIPAA and Data Protection, HIPAA Compliant, HL7, Machine Learning, Patient-Centric Billing Systems, Predictive Analytics, Real-Time Claims Processing, Remote Billing, telemedicine
Medical Billing White Guy

Medical billing plays a critical role in the healthcare industry, ensuring accurate reimbursement for services provided by healthcare providers. However, the traditional processes of medical billing have long been plagued by challenges such as complex coding systems, frequent changes in regulations, and increasing administrative burden. As technology continues to advance, the future of medical billing […]

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Automation, Blockchain Technology, EHR, HIPAA, HIPAA and Data Protection, Machine Learning, Medical Billing, Patient-Centric Billing Systems, Predictive Analytics, Real-Time Claims Processing, Reducing Rejected Claims, Remote Billing, Telemedicine

The Ultimate Guide to the Best Schools for Medical Billing and Coding

May 16, 2023 / admin / Articles, Billing, Coding, CPT, CPT Code, CPT Codes, HIPAA, Medical Billing, Medical Billing and Coding, Medical Billing and Coding FAQs, Medical Coder, Medical Coding
Medical Billing, Coding Universities, with Blonde Girl Studying

Are you passionate about healthcare administration and interested in pursuing a career in medical billing and coding? As the demand for skilled professionals in this field continues to grow, it’s crucial to choose the right educational institution that provides comprehensive training and prepares you for a successful career. We take a look at some of […]

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AAPC, AHIMA, American Academy of Professional Coders, American Health Information Management Association, Career Step, DeVry University, Drexel University, Keiser University, Medical Billing, medical billing education, medical billing programs, medical billing training, medical coding, medical coding education, medical coding training, University of Phoenix

Why is Credentialing So Important to Medical Providers?

May 12, 2023 / admin / Articles, Credentialing, Credentialing Accuracy, Credentialing AI, Credentialing On-Boarding, Healthcare, Healthcare Credentialing, HIPAA, HIPAA Compliant, Medical Credentialing
White Female Credentialing Professional

As the healthcare industry continues to grow and evolve, credentialing has become an essential aspect of ensuring the safety and quality of care provided to patients. Credentialing is the process of verifying a healthcare provider’s qualifications, experience, and professional history to ensure that they meet the necessary standards for patient care. We disclose why credentialing […]

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Credentialing, credentialing challenges, credentialing process, healthcare, healthcare credentialing, Medical, medical credentialing

The Future of Medical Billing

March 27, 2023 / admin / AI, Articles, Artificial Intelligence, Billing, Billing Services, Healthcare, Healthcare Billing, HIPAA, HIPAA Compliant, Medical, Medical Billing, Medical Billing AI, Telehealth, telemedicine
Medical Billing Credentialing Team

As medical technology continues to evolve, so does the way we manage and pay for healthcare. One area in particular that has seen significant changes in recent years is medical billing. Medical billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for medical services […]

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The Benefits and Challenges of Adopting Value-Based Care in Healthcare

March 19, 2023 / admin / Articles, EHR, Healthcare, HIPAA, Medical, Value Based Care, Value Based System, Value-Based, Value-based Care, Value-Based Care Adoption, Value-Based Care Models, Value-Based Models, Value-Based Pricing, VBC
medical-doctor-insurance-healthcare-billing

Value-based care (VBC) is a healthcare delivery model that aims to achieve better health outcomes and cost-effectiveness by focusing on the value of care provided to patients. This model shifts the focus from the traditional fee-for-service approach, where healthcare providers are paid based on the number of services they provide, to a system where providers […]

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EHR, healthcare, Healthcare Outcomes, HIPAA, Medical, Value Based Care, Value Based System, Value-Based, Value-Based Care Adoption, Value-Based Care Models, Value-Based Models, Value-Based Pricing, VBC

Which CPT Codes are Used in Genetic Testing Billing?

March 6, 2023 / admin / Articles, CPT Codes, Genetic Testing, Genetic Testing Billing, Genetic Testing Medical Billing, Healthcare, Healthcare Billing, HIPAA, HIPAA Compliant, Lab Billing, Laboratory Billing, Medical, Medical Billing
Genetic Testing Lab

Genetic testing has become an essential tool in medicine, providing valuable insights into a patient’s health and disease risk. As genetic testing becomes more prevalent, medical professionals must navigate the complex world of billing and coding for these tests. Correct coding ensures that the provider is reimbursed for the services provided, and it also provides […]

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CPT, CPT Code, CPT-10, genetic testing, genetic testing billing, Genetic Testing CPT Codes, genetic testing labs, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, Revenue Cycle Management

The Gravity of Medical Billing Compliance

February 23, 2023 / admin / Articles, Billing, Billing Best Practice, Billing Services, Claim Billing, HIPAA, HIPAA Compliant, Medical, Medical Billing, Medical Billing Best Practices
Medical Billing White Guy

Medical billing compliance refers to the adherence to laws, regulations, and ethical standards that govern the billing process. Billing procedures are complex and involve many stakeholders, including healthcare providers, patients, insurance companies, and government agencies. Compliance with regulations is critical to ensuring that healthcare providers receive reimbursement for services rendered, patients are charged correctly for […]

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AKS, Anti-Kickback Statute, billing, false claims act, FCA, Healthcare Billing, HIPAA, HIPAA Compliant, Medical Billing, Medical Billing Compliance, Medical Billing Regulation, Stark Law, The Health Insurance Portability and Accountability Act (HIPAA)

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

Medical Credentialing: Understanding the Process and Its Importance

February 1, 2023 / admin / Articles, Credentialing, Credentialing On-Boarding, Healthcare, Healthcare Credentialing, HIPAA, HIPAA Compliant, Medical Credentialing
Medical Credentialing Woman

The Process and Importance of Medical Credentialing What is Medical Credentialing? Medical credentialing is a vital process for ensuring the quality of healthcare services. It involves verifying the education, training, and professional experience of healthcare providers to ensure that they meet the standards for practicing in their field. This process helps to ensure that patients […]

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Credentialing, healthcare, healthcare credentialing, Medical, medical credentialing, what is medical credentialing

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

Uncompensated Healthcare: Charity Care and Bad Debt

January 18, 2023 / admin / Articles, Care, Charity Care, Charitycare, Healthcare, Healthcare Outcomes, Healthcare Practice, Healthcare Revenue, Healthcare Revenue Integrity, HIPAA, Medical, Revenue Cycle Management, Revenue Cycle Management (RCM), Uncompensated Healthcare
Charity Care Doctor

Uncompensated Healthcare in the Form of Charity Care and Bad Debt are Painful for Providers Uncompensated care is a widespread pain point for healthcare organizations, rising by just over a billion dollars in 2020 to $42.7 billion. And while it may not be thinkable to get rid of it, there are tactics you can introduce […]

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Charity Care, Charitycare, healthcare, Healthcare Debt, Medical, Medical Care, medical charity, rcm, Revenue Cycle Management (RCM), Uncompensated Healthcare

Why Aren’t Patients Using Patient Portals?

December 17, 2022 / admin / Healthcare, Healthcare Delivery, HIPAA, HIPAA Compliant, Medical, Medical Claims, Medical Providers, Patient Portal

Why Your Patients are Failing to Use Your Portal Properly Patient Portal Challenges Healthcare consumers vary from tech-savvy Generation Z, Y and Millennials, familiar with rapid click-throughs, to straightforward answers, to patients with little or no faith or proficiency in computing tools. In any instance, just a few words can sum up the probable value-added […]

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confusion, medical patients, medical practice, patient portal, patient portal problems, security

Balancing Social Media and Patient Privacy in Healthcare

November 18, 2022 / admin / Credentialing, HIPAA, HIPAA Compliant, Medical Billing, Patient Privacy, PHI, Privacy, Safety Violations, Social Media
social-media-hipaa-compliant

Social Media and Patient Privacy in Healthcare A Few Use Cases Use Case #1: Use Case #2: Protected Health Information (PHI) Preserving privacy of patients’ protected health information (PHI) is one of the major concerns linked to social media in healthcare. Privacy and protection of such information are dealt with in federal law and overseen […]

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facebook healthcare, HIPAA, HIPAA Compliant, instagram healthcare, Internet HIPAA, Medical Billing, medical credentialing, patient privacy, PHI, privacy, safety violations, social media, social media healthcare, social media HIPAA, social media medical

Higher Accuracy of Medical Claims Saves Revenue

July 10, 2021 / admin / Articles, HIPAA, HIPAA Compliant, Medical Billing, Medical Billing Companies, Medical Billing Cost, Medical Claims, Revenue Cycle Management
Medical Billing Techniques

Healthcare Practices Save Money with Higher Accuracy of Medical Claims Reimbursement for medical practices has been impacted by numerous trends and healthcare industry changes over the past five to ten years. Medicare and Medicaid are constantly cutting physician reimbursement, third-party payers (UnitedHealth, BCBS, Humana, Anthem, Aetna, Cigna, etc.) have bargained for fee-for-service contracts with healthcare […]

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healthcare rcm, healthcare revenue cycle, HIPAA, Medical Billing, medical claim accuracy, medical claims, outsourced billing, outsourced medical billing, rcm, Revenue Cycle Management, revenue loss
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Recent Posts

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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

  • Laboratory Billing

    Which CPT Codes are Used in Laboratory Billing?

  • 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

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