Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Payer Rejection

Claim Denial vs. Rejection: What’s the Difference?

February 23, 2024 / admin / Articles, Claim Denial, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Claims Management, Clearinghouse Rejection, Denial Management, Denial Prevention Strategy, Denial Trends, Denial vs Rejection, Denied Claims, Denied Medical Claims, Payer Rejection, Rejected Claims
Medical Claim Denied Doctor

In the healthcare industry, there are two main ways that insurance companies respond when they decide not to pay a claim – denial and rejection. Both indicate the claim will not be paid, but there are some important differences between the two. Understanding the distinction is critical for medical providers to correctly follow-up so they […]

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Claim Denial, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Clearinghouse Rejection, Denial vs Rejection, Denied Claims, Healthcare, Healthcare Billing, Medical, Medical Billing, Payer Rejection, RCM, Revenue Cycle, 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

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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

  • Abstract, Punk Rock Female Medical Doctor

    What are Peer and Professional References in Credentialing?

  • Older, Female Medical Doctor Writing a Prescription

    Healthcare Consolidation: How It Affects (Credentialing Timelines)

  • Explanation of Benefits or EOB

    EOBs: A Guide to Explanation of Benefits

  • 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

  • Caucasian Red-Headed Male Medical Doctor

    Value-Based Care Billing: Preparing for the Transition

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