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Medicare Coverage

Getting In-Network with Medicare

October 9, 2025 / Alex J. Lau / Eligibility, Eligibility Verification, Enrollment, In-Network, In-Network Credentialing, In-Network with Medicare, Medicare, Medicare 101, Medicare Advantage, Medicare Coverage, Medicare In-Network
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 / Alex J. Lau / 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 / Alex J. Lau / 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 / Alex J. Lau / 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

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Recent Posts

  • Modifier 96 versus Modifier 97

    Modifier 96 vs. Modifier 97: What Therapy Billers Need to Know

  • 'Revalidation versus Recredentialing' Neon Sign

    Revalidation vs. Recredentialing: What’s the Difference? (2026 Guide)

  • CAQH Credentialing Expert at Machine

    How to Get Providers Credentialed in 60 Days: A Week-by-Week Guide

  • Ghost Provider or Doctor Roaming the Hallways of a Hospital

    The Ghost Provider Problem: CAQH Lapse & Denials

  • Latina Medical Physician Smiling Needing Credentialing

    Why Credentialing Gets Delayed: 6 Causes & Fixes

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