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  • Payer Contracting (Page 2)

Payer Contracting

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 […]

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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, 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

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. Enrolling with payers allows providers to gain the ability to […]

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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

February 11, 2023 / admin / Articles, Contracting, Healthcare, Medical, Payer Contract, Payer Contracting, Payer Contracts, Payer Negotiation, Payer Relations, Rate Negotiations, 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 […]

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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 Contracting White Female

Hiring new providers brings energy and growth to any medical practice. Whether you’re bringing on a physician, nurse practitioner, or physician assistant, adding talented healthcare professionals to your team opens doors to serving more patients and expanding your services. But there’s a catch that trips up even experienced practice managers, getting these new providers ready […]

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Credentialing, credentialing on-boarding, Enrollment, Healthcare, Healthcare Credentialing, Medical Credentialing, 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
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Recent Posts

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  • Female Medical Doctor PECOS User

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  • 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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