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

Recent Posts

  • Bridge Gap Healthcare Business

    Bridging the Credentialing Gap Between Payer & Provider Organizations

  • CareSource Credentialing

    A Guide to Provider Credentialing with CareSource

  • Middle-Aged White Male Medical Doctor

    Credentialing Denials: The Ugly Truth

  • Behavioral Health Credentialing, Billing & Contracting Use Case

    Use Case: Behavioral Health Contracting

  • Group of Medical Doctors Discussing Charge Capture at Hospital

    10 Billing KPIs Every Healthcare Provider Should Know

  • Tax Status Dictates Contract Structure (Doctor Signing)

    Tax Status Dictates Contract Structure

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
  • Primary Care
  • 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
  • Primary Care
  • 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

  • Bridge Gap Healthcare Business

    Bridging the Credentialing Gap Between Payer & Provider Organizations

  • CareSource Credentialing

    A Guide to Provider Credentialing with CareSource

  • Middle-Aged White Male Medical Doctor

    Credentialing Denials: The Ugly Truth

  • Behavioral Health Credentialing, Billing & Contracting Use Case

    Use Case: Behavioral Health Contracting

  • Group of Medical Doctors Discussing Charge Capture at Hospital

    10 Billing KPIs Every Healthcare Provider Should Know

  • Tax Status Dictates Contract Structure (Doctor Signing)

    Tax Status Dictates Contract Structure

  • Blonde Female Healthcare Provider / Owner

    New NCQA 2025 Rules and Their Impact

  • Black Male and Female Medical Doctors

    Payer Contracting: Unlock Your Revenue Potential

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