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Medicare Coverage

Getting In-Network with Medicare

October 9, 2025 / admin / Articles, Eligibility, Eligibility Verification, Enrollment, In-Network, In-Network Credentialing, In-Network with Medicare, Medicare, Medicare 101, Medicare Advantage, Medicare Coverage, Medicare In-Network
Male Asian Indian-American Medical Doctor in Need of Credentialing

For healthcare providers looking to expand their patient base and establish a stable revenue stream, becoming an in-network Medicare provider represents a significant opportunity. With over 66 million Americans enrolled in Medicare, this federal health insurance program serves as a cornerstone of healthcare coverage in the United States. However, the process of joining Medicare’s network […]

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Eligibility, Eligibility Verification, Enrollment, In-Network, In-Network Credentialing, In-Network with Medicare, Medicare, Medicare 101, Medicare Advantage, Medicare Coverage, Medicare In-Network

Medicare Reimbursement: Understanding the Labyrinth

April 3, 2024 / admin / Articles, Geographical Practice Cost Index, Inpatient Prospective Payment System, IPPS, Medicare, Medicare Coverage, Medicare Reimbursement, Medicare Severity Diagnosis Related Groups, MS-DRG, OPPS, PPS, Prospective Payment Systems
Medicare Labyrinth

If you’re a healthcare provider or facility dealing with Medicare, one thing is certain, getting properly reimbursed is a maze filled with complex rules, convoluted paperwork, and often, sheer frustration. Medicare reimbursement is the lifeblood that keeps many healthcare operations afloat, but navigating its serpentine pathways can feel like a daily battle. Buckle up as […]

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APC, APCs, CMS, Geographical Practice Cost Index, Healthcare, Healthcare Billing, Inpatient Prospective Payment System, IPPS, Medical, Medical Billing, Medicare, Medicare Billing, Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D, Medicare Physician Fee Schedule, Medicare Reimbursement, Medicare Severity Diagnosis Related Groups, MIPS, MS-DRG, OPPS, Prospective Payment Systems, Revenue Cycle, Revenue Cycle Management

Skilled Nursing Facility Versus Nursing Home

December 18, 2022 / admin / Articles, Medical, Medical Billing, Medical Providers, Medicare, Medicare Coverage, Nursing Home, Old Folks Home, Skilled Nursing, Skilled Nursing Billing, Skilled Nursing Facility

What’s the Difference Between a Skilled Nursing Facility and a Nursing Home? On the surface, a skilled nursing facility and a nursing home may appear rather the same. In fact, some care facilities actually function as both, with a distinct floor or section of a building dedicated to each. The difference between a skilled nursing […]

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Billing, Medical Billing, Medical Billing Service, Nursing Billing, Nursing Facility Billing, Nursing Home, Old Folks Home, Skilled Nursing, Skilled Nursing Billing, Skilled Nursing Facility, Skilled Nursing Facility Billing

Does Medicare Cover (Mental Health Services) such as Therapy?

February 9, 2022 / admin / Articles, Behavioral Health, Behavioral Health Billing, Healthcare, Healthcare Outcomes, Medicare Coverage, Mental Health, Mental Health Billing
Mid 60's White Female Credentialing Expert

Behavioral / Mental Health Services + Medicare Sometimes it can be problematic for older adults to differentiate indicators of mental health difficulties for typical aging-related changes. They may think that experiencing sadness or anxiety is an ordinary symptom of growing older, particularly when they live with taxing health conditions or lose loved ones. Deteriorating health […]

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Behavioral Health, Behavioral Health Billing, Medicaid, Medicare, Medicare Coverage, Medicare Therapy, Mental Health, Mental Health Billing

Recent Posts

  • CAQH Profile Current -- Two Doctors

    Common CAQH Application Mistakes

  • Telehealth Credentialing: Pretty, Black Female Credentialer

    Case Study: A Six-State Telehealth Credentialing Challenge

  • Doctors Adopting Value-Based Care

    How Value-Based Care Reimbursement Works for Clinics and Hospitals

  • White Male Medical Doctor Looking at Healthcare Regulatory Updates

    Regulatory Deep Dives: Managing Healthcare Policy Changes

  • Female Medical Doctor PECOS User

    What is PECOS and its 7 Key Benefits?

  • In-House vs. Outsourced Credentialing. Two scenarios.

    Cost-Benefit Analysis: In-House vs. Outsourced Credentialing

Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Home Health
  • Urgent Care
  • Radiology
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Orthopedic & Rheumatology
  • Genetic Testing
  • Geriatric Medicine
  • Pharmacogenetic (PGx)
  • Fertility Preservation
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • Biologics & Specialty Drugs
  • Telestroke & 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
  • Home Health
  • Urgent Care
  • Radiology
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Orthopedic & Rheumatology
  • Genetic Testing
  • Geriatric Medicine
  • Pharmacogenetic (PGx)
  • Fertility Preservation
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • Biologics & Specialty Drugs
  • Telestroke & 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

  • CAQH Profile Current -- Two Doctors

    Common CAQH Application Mistakes

  • Telehealth Credentialing: Pretty, Black Female Credentialer

    Case Study: A Six-State Telehealth Credentialing Challenge

  • Doctors Adopting Value-Based Care

    How Value-Based Care Reimbursement Works for Clinics and Hospitals

  • White Male Medical Doctor Looking at Healthcare Regulatory Updates

    Regulatory Deep Dives: Managing Healthcare Policy Changes

  • Female Medical Doctor PECOS User

    What is PECOS and its 7 Key Benefits?

  • In-House vs. Outsourced Credentialing. Two scenarios.

    Cost-Benefit Analysis: In-House vs. Outsourced Credentialing

  • Payer Contracting Experts Talking in a Healthcare Group HQ

    Payer Contracting: Maximize Your Rates

  • Credentialing Workflow Expert, a Latino Male Credentialer

    Smarter Workflows Reduce Credentialing Turnaround Time

  • Healthcare Organization Admins Talking, Walking

    ERAs vs. Real-Time Claim Status Checks: What’s the Difference?

  • Modifier 59 on screen, female medical coder

    How to Use Modifier 59 Correctly

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