Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Prior Authorizations

What is Prior Authorization?

September 19, 2025 / admin / Articles, Diagnostic Imaging, Pre-Approval, Pre-Authorization, Pre-Authorization Process, Prior Authorization, Prior Authorization Process, Prior Authorizations, Services Requiring Prior Authorization
Female Mulatto Doctor Prior Authorization

Prior authorization is a fundamental healthcare process that requires healthcare providers to obtain approval from insurance companies or healthcare organizations before delivering specific medical services, treatments, or procedures to patients. This approval mechanism serves as a crucial gatekeeping function that ensures medical services are medically necessary, cost-effective, and appropriate for the patient’s condition before they […]

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Articles, Diagnostic Imaging, Pre-Approval, Pre-Authorization, Pre-Authorization Process, Prior Authorization, Prior Authorization Process, Prior Authorizations, Services Requiring Prior Authorization

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

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Practices Served

  • Behavioral Health
  • Primary Care
  • 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
  • Podiatry
  • 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
  • Primary Care
  • 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
  • Podiatry
  • 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

  • AI Black Male Medical Doctor Touches Robot Finger

    AI’s Ethical Frontier: Managing Healthcare’s Data Morality

  • FHIR Data Exchange Interoperability

    FHIR® Interoperability: The Hidden RCM Benefit of Real-Time Data Exchange

  • Anthem BCBS Credentialing, Recredentialing, and Contracting

    A Guide to Provider Credentialing with Anthem

  • Colonoscopy CPT Codes with Asian Doctor

    Which CPT Codes are Used in Colonoscopy Billing?

  • White Male Doctor Challenged by RCM

    Rate Negotiations: Get Paid What You Deserve

  • Asthma Treatment CPT Codes

    Which CPT Codes are Used in Asthma Treatment Billing?

  • Male Asian Indian-American Medical Doctor in Need of Credentialing

    The Difference Between Provider and Group Credentialing?

  • White Male Doctor, High Certification

    Which Medical Certification Pays the Most?

  • White Male Telehealth Doctor on Screen

    Do I Need Separate Credentialing for Telehealth?

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