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

Payer Contracting

Maximizing Healthcare Provider Reimbursement

August 9, 2024 / admin / Articles, Charge Capture, Data Analytics, Denial Management, Fee Schedule, Medical Coding, Outsourced Billing, Payer Contract, Payer Contracting, RCM, Reimbursement, Reimbursement Models, Reimbursement Optimization, Value-based Care
Medical Reimbursement

Achieving maximum reimbursement is crucial for healthcare providers to maintain financial stability and continue delivering high-quality patient care. We explore key strategies and best practices that healthcare providers in the United States can implement to optimize their reimbursement processes and maximize revenue. Understanding the Reimbursement Landscape Before diving into specific strategies, it’s essential to understand […]

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Charge Capture, Data Analytics, denial management, Fee Schedule, medical coding, outsourced billing, Payer Contract, Payer Contracting, rcm, reimbursement, Reimbursement Models, Reimbursement Optimization, Value Based Care

How to Optimize Billing Reimbursement

August 7, 2024 / admin / Articles, Automation, Charge Capture, Denial Management, Denial Management Process, Patient Collections, Payer Contracting, Payer Contracts, Payer Enrollment, Payor Contract, Prior Authorization, Prior Authorization Process, Prior Authorizations, Proper Coding, RCM, Revenue Cycle, Value-Based Models
Navigating Fee Schedules and Reimbursement Rates

Effective billing practices are crucial for healthcare providers, medical offices, and businesses across various industries to maintain financial stability and ensure proper compensation for services rendered. Optimizing reimbursement in billing involves implementing strategic processes, leveraging technology, and staying compliant with industry regulations. We discuss key strategies and best practices to maximize reimbursement rates and streamline […]

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Automation, Charge Capture, denial management, Denial Management Process, Patient Collections, Payer Contracting, Payer Contracts, Payer enrollment, Payor Contract, prior authorization, Prior Authorization Process, Prior Authorizations, Proper Coding, rcm, Revenue Cycle, Value-Based Models

The Intricacies of Payer Contracting

August 6, 2024 / admin / Articles, Payer Contract, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Payer Regulations, Payor Contract, Payor Contracting
Payer Contracting Negotiation

Few areas are as crucial yet as misunderstood as payer contracting. This process, which forms the backbone of financial transactions between healthcare providers and insurance companies, plays a pivotal role in shaping the healthcare landscape. From determining reimbursement rates to influencing patient access to care, payer contracting impacts every facet of the healthcare ecosystem. We […]

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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

The Importance of Negotiating Payer Contracts

April 19, 2024 / admin / Articles, Payer Contract, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Payer Regulations, RCM, Revenue Cycle Management, Revenue Cycle Process
Payer Contracting White Female

Healthcare providers, chances are you’re all too familiar with the headaches that come with negotiating contracts with insurance payers. It’s a tedious process that often leaves you feeling like you’re getting the short end of the stick. But here’s the thing – re-negotiating those contracts on a regular basis is absolutely crucial for the financial […]

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billing, Contract Negotiations, healthcare, Medical, Medical Billing, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer enrollment, Payer Negotiation, Payer Regulations, rcm, Revenue Cycle, Revenue Cycle Management

How to Renegotiate Your Payer Contracts

April 15, 2024 / admin / Articles, Data Analytics, Payer Contract, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Reimbursement, Reimbursement Models, Reimbursement Rates, Renegotiate Payer Contracts
Renegotiating Payer Contracts

So, it’s that time again. Your payer contracts are up for renewal and you need to renegotiate. Maybe you’re feeling like the reimbursement rates they’re offering are way too low. Or the administrative burdens and preauthorization requirements have gotten out of hand. Whatever the reason, you know you need to go back to the negotiating […]

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Payer Contract, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer enrollment, Payer Negotiation, reimbursement, Reimbursement Models, reimbursement rates, Renegotiate Payer Contracts

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

Payer Enrollment vs. Credentialing: Understanding The Differences

November 13, 2023 / admin / Articles, Enrollment, Payer Contract, Payer Contracting, Payer Enrollment, Payer Negotiation, RCM, RCM Challenges, Revenue Cycle Management, Revenue Cycle Management (RCM), Revenue Cycle Management Challenges
Medical Billing Credentialing Team

What is Payer Enrollment? Payer enrollment is a process by which healthcare providers enroll with insurance companies to receive payment for services rendered. This process involves completing an application, providing necessary documentation, and meeting specific requirements set by the payer. The payer may review the application and documentation to determine if the healthcare provider meets […]

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Credentialing, credentialing process, enrollment, healthcare, Medical, medical credentialing, Payer Contracting, Payer enrollment

Payer Enrollment: Streamlining Healthcare Billing and Reimbursement

June 30, 2023 / admin / Articles, Credentialing, Healthcare, Medical, Medical Billing, Payer Contract, Payer Contracting, Payer Enrollment, Payer Negotiation, Provider Credentialing, Provider-Payer, Reimbursement, Reimbursement Rates, Reimbursement Regulations, Revenue Cycle Management
Payer Contracting White Female

Understanding Payer Enrollment What is Payer Enrollment? Payer enrollment refers to the process through which healthcare providers, such as hospitals, clinics, and individual practitioners, become registered with insurance payers or healthcare plans. It involves submitting the necessary documentation and information to establish a contractual relationship with these payers. By enrolling with payers, providers gain the […]

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Credentialing, healthcare, Healthcare Billing, healthcare credentialing, Medical, Medical Billing, Medical Billing Service, medical credentialing, payor enrollment, Revenue Cycle Management, revenue cycle optimization

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

Payer Contracting Demystified: A Comprehensive Guide for Healthcare Providers

February 11, 2023 / admin / Articles, Contracting, Credentialing, Healthcare, Medical, Medical Credentialing, Network Participation, Patient Satisfaction, Payer Contract, Payer Contracting, Payer Enrollment, Payer Negotiation, Reimbursement Rates
Payer Contracting White Female

In this article, we aim to provide a comprehensive understanding of payer contracting for healthcare providers, simplifying the process and highlighting the essential aspects to keep in mind. Introduction to Payer Contracting Payer contracting is crucial for healthcare providers as it helps ensure that they receive adequate reimbursement for their services, enabling them to provide […]

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healthcare, healthcare payor contracting, Medical, medical payor contracting, patient satisfaction, payor contracting, payor contracting process, payor enrollment, payor healthcare

Payer Contracting, What Healthcare Providers Should Understand

November 7, 2022 / admin / Articles, Credentialing, Credentialing On-Boarding, Enrollment, Healthcare Credentialing, Healthcare Outcomes, Measuring Healthcare Outcomes, Medicaid, Medical Credentialing, Medicare, Payer Contracting, Private Insurers
Payer Contracting White Female

Let’s begin with this set-up: Let’s say you’re hunting for a new job and receive a call from a would-be employer informing you that the job is yours. Of course, you’re thrilled by the news and inquire about your starting salary. Your new employer replies that you need to wait for your first paycheck to […]

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Credentialing, healthcare credentialing, medicaid, medicare, private insurers, Provider Credentialing, provider networks, reimbursement rates

Payer Enrollment Versus Credentialing, What’s the Difference?

November 6, 2022 / admin / Credentialing, Credentialing On-Boarding, Enrollment, Healthcare, Healthcare Credentialing, Payer Contracting, Payer Enrollment, Payer Negotiation
Payer Contracting White Female

Bringing new providers aboard is invigorating, yet a complex process with plenty of moving parts. If you’ve ever had the opportunity to hire a physician or mid-level professional, you know just how much work is involved. Payer enrollment is maybe one of the more essential, yet misunderstood pieces of the puzzle. No doubt, making your […]

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Credentialing, credentialing on-boarding, enrollment, healthcare, healthcare credentialing, medical credentialing, Payer Contract, Payer Contracting, Payer enrollment

How COVID-19 Affected the Provider-Payer Relationship

March 23, 2022 / admin / Articles, Corona Virus, Coronavirus, Coronavirus Testing, Coronavirus Testing Billing, COVID, COVID Test Kits, COVID Testing Billing, COVID-19, COVID-19 Billing, COVID-19 Testing, COVID-19 Testing Billing, Payer Contract, Payer Contracting, Payer Enrollment, Payer Negotiation, Provider-Payer
COVID-19 Testing Billing

Provider-Payer Relationship Under COVID-19 COVID-19 Upset Provider-Payer Relationships The COVID-19 pandemic has affected most, if not all, businesses everywhere. For healthcare, in particular, the pandemic and its consequences altered the ways that payers and providers do business with one another. How So? Let’s catch a momentary peek at several of the more immediate effects on […]

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Coronavirus, Coronavirus billing, COVID billing, COVID test kits, COVID testing billing, COVID-19, COVID-19 testing, Healthcare Billing, Medical Billing, outsourced billing, outsourced medical billing, provider-payor

Recent Posts

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  • Older Female Doctor in need of Credentialing

    Credentialing Problems? We Can Fix Them!

  • Medical Credentialing State-by-State

    Multi-State Licensing in Provider Credentialing

  • Telehealth Provider

    Solutions for Telehealth Credentialing Challenges

  • Telehealth Credentialing Specialist

    What is Telehealth Credentialing?

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

  • 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

  • Telehealth Provider

    Solutions for Telehealth Credentialing Challenges

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