Billing & Credentialing Cranberry Twp. (Pittsburgh)
  • Facebook
  • Instagram
  • Linkedin
  • Twitter
  • YouTube
  • RSS
Call: (412) 219-4789 | Fax: (866) 422-9277
  • Credentialing
  • Payer Contracting
  • Medical Billing
  • Rate Negotiations
  • Specialties
    • Behavioral Health
    • 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
    • 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
  • Blog
  • Contact
  • Home
  • Payer Contracting

Payer 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 […]

Read More

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

Building Profitable Relationships Through Payer Contracting

September 10, 2025 / admin / Articles, Payer Contract, Payer Contract Management, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payor Contract Management, Payor Contracting, Reimbursement, Reimbursement Rates
Payer Contract Management in Healthcare

Healthcare providers today face an increasingly challenging landscape when it comes to securing favorable contracts with insurance payers. The art of payer contracting goes far beyond simply negotiating rates, it’s about creating mutually beneficial partnerships that drive sustainable revenue growth while maintaining quality patient care. When done right, these relationships become the foundation of a […]

Read More

Payer Contract, Payer Contract Management, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payor Contract Management, Payor Contracting, Reimbursement, Reimbursement Rates

10 Payer Contracting Use Cases

September 4, 2025 / admin / Articles, Payer Contract, Payer Contract Management, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payor Contract Management, Payor Contracting, Reimbursement, Reimbursement Rates
Payer Contract Negotiations, with White Male Medical Doctor

Payer contracting can make or break a healthcare organization’s financial health. The difference between a well-negotiated contract and a mediocre one often means millions in revenue over the contract term. At Medwave, we’ve helped many thousands of healthcare providers optimize their payer relationships, and we’ve seen firsthand how the right approach transforms both revenue and […]

Read More

Payer Contract, Payer Contract Management, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payor Contract Management, Payor Contracting, Reimbursement, Reimbursement Rates

How to Restructure Payer Contracts

August 31, 2025 / admin / Articles, Contract Management, Payer Contract, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Payer Regulations, Payor Contract, Payor Contracting
Agreement to Negotiate Contracts in Healthcare

Healthcare providers often believe they have limited options when it comes to improving their payer contracting income. This assumption couldn’t be further from the truth. Contract negotiation and contract management represent powerful tools your healthcare organization can leverage to enhance current contracts and increase revenue substantially. The challenge lies in execution. Many physicians struggle to […]

Read More

Payer Contract, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Payer Regulations, Payor Contract, Payor Contracting

Payer Contract Management Strategies for Healthcare Providers

August 27, 2025 / admin / Payer Contract, Payer Contract Management, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payor Contract Management, Payor Contracting, Reimbursement, Reimbursement Rates
Payer Contract Management in Healthcare

Healthcare providers face mounting pressure to optimize their revenue streams while maintaining quality patient care. At the heart of this challenge lies payer contract management, a critical function that directly influences both financial sustainability and patient access to services. Knowing how to negotiate, manage, and optimize these agreements can mean the difference between thriving and […]

Read More

Payer Contract, Payer Contract Management, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payor Contract Management, Payor Contracting, Reimbursement, Reimbursement Rates

How to Properly Negotiate Payer Contracts

June 8, 2025 / admin / Articles, Payer Contract, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Payor Contract, Payor Contracting, Payor Credentialing, Payor Negotiation
Payer Contracting Negotiation

Few things impact a practice’s financial health more than payer contracts. These agreements determine not just your reimbursement rates, but also define the rules of engagement between your practice and insurance companies. Yet many healthcare providers approach contract negotiations with a mixture of dread and resignation, assuming they lack leverage against powerful payers. The truth? […]

Read More

Payer Contract, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Payor Contract, Payor Contracting, Payor Credentialing, Payor Negotiation

Key Performance Indicators That Drive Payer Contract Decisions

January 31, 2025 / admin / Articles, Contract Management, Payer Contract, Payer Contract Negotiation, Payer Contracting, Payer Contracts, Payer Negotiation, Payer Regulations, Payor Contract, Payor Contracting
Group of diverse medical doctors in scrubs, smiling

Healthcare payers operate in a data-rich environment where every contract decision can impact millions of dollars in claims, member satisfaction, and regulatory compliance. The metrics that guide these decisions go far beyond simple cost considerations, encompassing quality outcomes, network adequacy, and member experience factors that directly influence an organization’s competitive position and financial health. Smart […]

Read More

Contract Management, Payer Contract, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Payer Regulations, Payor Contract, Payor Contracting

Maximizing Healthcare Provider Reimbursement

August 9, 2024 / admin / Articles, Charge Capture, Data Analytics, Denial Management, Fee Schedule, Medical Coding, Payer Contract, Payer Contracting, RCM, Reimbursement, Reimbursement Models, Reimbursement Optimization, Value-Based Care
Elderly White Female Doctor with White Male Residents

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. Healthcare Reimbursement Before diving into specific strategies, it’s essential to understand reimbursement. The […]

Read More

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 […]

Read More

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 […]

Read More

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 […]

Read More

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 […]

Read More

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, HIPAA Compliance, Patient Eligibility, Patient Insurance Eligibility, Payer Contracting, RCM, Revenue, Revenue Cycle Management, 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 […]

Read More

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 […]

Read More

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 […]

Read More

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 […]

Read More

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

We aim to provide an understanding of payer contracting for healthcare providers, simplifying the process and highlighting the essential aspects to keep in mind. Payer contracting is crucial for healthcare providers as it helps ensure that they receive adequate reimbursement for their services, enabling them to provide high-quality care to their patients. As a healthcare […]

Read More

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 […]

Read More

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 […]

Read More

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 […]

Read More

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

  • A White, Male Medical Doctor Signing Paperwork. Sitting at a desk.

    Top 25 Physician Procedures w/ CPT Codes

  • Amazon Healthcare One Medical

    Amazon’s Healthcare Revolution: Transforming Patient Care

  • robotic-process-automation-RPA-example-code

    How RPA Can Save Your Medical Billing

  • Group of Ethnically Diverse Medical Doctors Discussing Charge Capture

    Getting Charge Capture Right

  • A White, Male Medical Doctor Signing Paperwork. Sitting at a desk.

    Value-Based Care Billing: Preparing for the Transition

  • Female Mulatto Doctor Prior Authorization

    What is Prior Authorization?

Practices Served

  • Behavioral Health
  • 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
  • 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
  • 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
  • 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

  • A White, Male Medical Doctor Signing Paperwork. Sitting at a desk.

    Top 25 Physician Procedures w/ CPT Codes

  • Amazon Healthcare One Medical

    Amazon’s Healthcare Revolution: Transforming Patient Care

  • robotic-process-automation-RPA-example-code

    How RPA Can Save Your Medical Billing

  • Group of Ethnically Diverse Medical Doctors Discussing Charge Capture

    Getting Charge Capture Right

  • A White, Male Medical Doctor Signing Paperwork. Sitting at a desk.

    Value-Based Care Billing: Preparing for the Transition

  • Female Mulatto Doctor Prior Authorization

    What is Prior Authorization?

  • Twin White Male Medical Doctors Looking at Each Other

    What Comes First: Credentialing or Contracting?

  • Artificial Intelligence Robot Thinking

    How AI Saves Your Medical Practice (Money)

Quick Links

  • About Medwave
  • Google Reviews
  • CAQH ProView Form
  • On-Boarding Documentation Checklist
  • Billing / Credentialing Specialties
  • Regions Served
  • New Practice
  • Medical Credentialing
  • Recredentialing
  • Payer Contracting
  • Medical Billing
  • Rate Negotiations
  • Denial Management
  • HL7 Integration
  • Robotic Process Automation (RPA)
  • A/R Recovery
  • Telehealth Billing
  • Revenue Cycle Consulting
  • CPT Code Category Index
  • FAQ
  • Pricing
  • Blog
  • HIPAA Compliance
  • Contact

Quick Connect

  • (412) 219-4789
  • Fax: (866) 422-9277
  • Contact Us
    • Linkedin
    • YouTube
    • Facebook
    • Twitter
    • Pinterest
    • Instagram

Medwave @ Goodfirms

Medwave | Alignable

Medwave @ Inc. 5000

© 2025, Medwave Medical Billing, LLC. | Cranberry Township, PA, 16066 | Phone: (412) 219-4789 | Fax: (866) 422-9277 | Sitemap | Privacy Policy