Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Call: (412) 219-4789 | Fax: (866) 422-9277
  • Credentialing
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    • Behavioral Health
    • DME
    • Urgent Care
    • Speech Therapy
    • Geriatric Medicine
    • Skilled Nursing Facilities (SNF)
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    • Genetic Testing
    • Pharmacogenetic (PGx)
    • Toxicology
    • Allergy Testing
    • Oncology
    • Pathology
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  • Reimbursement

Reimbursement

How RPA Can Save Your Medical Billing

September 22, 2025 / admin / Articles, Automated Billing, Automation, Billing Automation, Manual Billing, RCM, RCM AI, Reimbursement, Revenue Cycle Management, Revenue Cycle Management AI, Robotic Process Automation, RPA, RPA Adoption
robotic-process-automation-RPA-example-code

Medical billing has become the backbone of healthcare revenue, yet it remains one of the most challenging aspects of running a medical practice. Between changing regulations, insurance requirements, and the constant pressure to reduce claim denials, billing departments are stretched thin while managing increasingly demanding workloads. The statistics paint a sobering picture: the average medical […]

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Automated Billing, Automation, Billing Analytics, Billing Automation, Manual Billing, RCM, Reimbursement, Revenue Cycle, Revenue Cycle Management, Robotic Process Automation, RPA, RPA Adoption

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 […]

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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 […]

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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 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 […]

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

Tough Questions Providers May Ask Billers

December 1, 2024 / admin / Articles, Billing, Claim Denial Rate, Claim Denials, Compliance, EHR, EMR, Interoperability, Medical Billers, Medical Billing, Medical Billing Questions, Modifiers, Reimbursement, Reimbursement Models, Reimbursement Optimization
Latina Female Medical Provider Owner

The relationship between medical providers and their billing teams has become increasingly crucial to practice success. As reimbursement models grow more complicated and regulatory requirements more stringent, providers often find themselves grappling with challenging questions about their revenue cycle management. We’ll address the most demanding and complex questions that medical providers frequently ask their billing […]

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Billing, Claim Denial Rate, Claim Denials, Compliance, EHR, EMR, Interoperability, Medical Billers, Medical Billing, Medical Billing Questions, Modifiers, Reimbursement, Reimbursement Models, Reimbursement Optimization

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 […]

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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

Navigating Fee Schedules and Reimbursement Rates

May 12, 2024 / admin / Articles, Fee Schedule, Fee Schedules and Reimbursement Rates, Optimizing Reimbursements, Reimbursement, Reimbursement Model Shift, Reimbursement Models, Reimbursement Optimization, Reimbursement Rates, Reimbursement Regulations
Navigating Fee Schedules and Reimbursement Rates

Few topics get finance teams and medical billing professionals quite as fired up as fee schedules and reimbursement rates. It’s the core of how healthcare providers generate revenue and keep operations humming. At the same time, it’s an arena loaded with complexity, regulatory scrutiny, and often mind-numbing minutiae. If you’re reading this, you’re probably intimately […]

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Fee Schedule, Fee Schedules and Reimbursement Rates, Optimizing Reimbursements, Reimbursement, Reimbursement Model Shift, Reimbursement Models, Reimbursement Optimization, Reimbursement Rates, Reimbursement Regulations

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 […]

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Payer Contract, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Reimbursement, Reimbursement Models, Reimbursement Rates, Renegotiate Payer Contracts

Exploring the Integration of ChatGPT in Revenue Cycle Management

February 24, 2024 / admin / AI-driven RCM, Articles, Billing, ChatGPT, ChatGPT in Healthcare, ChatGPT in RCM, ChatGPT in Reimbursement, Healthcare KPIs, Healthcare Outcomes, Healthcare Revenue, Medical Billing, OpenAI, RCM, RCM Challenges, Reimbursement, Revenue Cycle, Revenue Cycle Management
ChatGPT Revenue Cycle Management

As the healthcare industry continues to embrace technological innovations, the integration of artificial intelligence (AI) solutions like ChatGPT in Revenue Cycle Management (RCM) holds immense promise for optimizing financial processes and improving operational efficiency. We cover potential applications and challenges associated with leveraging ChatGPT in RCM. Understanding Revenue Cycle Management Before delving into the potential […]

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Accounts Receivable, AI-driven RCM, ChatGPT, ChatGPT Healthcare, ChatGPT in Healthcare, ChatGPT in RCM, ChatGPT in Reimbursement, Healthcare AI, Healthcare KPIs, Medical AI, Medical KPIs, OpenAI, Revenue Cycle Management

The Challenges and Opportunities of Digital Therapeutics (DTx) Reimbursement

February 19, 2024 / admin / Articles, Digital Health Center of Excellence, Digital Therapeutics, DTx, DTx Billing, DTx Reimbursement, Integration, Real-World Evidence, Reimbursement, Reimbursement Models, Revenue Cycle, Revenue Cycle Management, RWE
Digital Therapeutics Reimbursement

The healthcare industry is undergoing a digital transformation, with software-based therapeutic interventions known as digital therapeutics emerging as disruptive new modalities to prevent, manage, and treat a growing range of medical conditions. Digital Therapeutics Breakdown Digital therapeutics deliver evidence-based treatments directly to patients through smart devices and applications. These data-driven tools provide personalized interventions, feedback, […]

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Digital Health Center of Excellence, Digital Therapeutics, DTx, DTx Billing, DTx Reimbursement, Healthcare, Integration, Interoperability, Interoperability and Integration, Medical, Medical Billing, Optimize Reimbursement, Real-World Evidence, Reimbursement, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, RWE

Manual Medical Billing is Dead, RPA is the Answer

February 11, 2024 / admin / Articles, Automated Billing, Automation, Billing Analytics, Billing Automation, Manual Billing, RCM, Reimbursement, Revenue Cycle, Revenue Cycle Management, Robotic Process Automation, RPA, RPA Adoption, RPA HL7
robotic-process-automation-RPA-example-code

Medical billing has long relied on manual data entry and paperwork to process claims. But this antiquated approach is no longer sustainable in today’s digital healthcare environment. The future of medical billing lies with robotic process automation (RPA). RPA automates repetitive data entry and workflow tasks, increasing efficiency, reducing human error, and allowing medical billers […]

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Billing Analytics, Billing Automation, Healthcare, Healthcare Billing, Manual Billing, Medical, Medical Billing, Medical Billing Robotic Process Automation, RCM, Revenue Cycle, Revenue Cycle Management, Robotic Process Automation, RPA, RPA Adoption

The Secret Sauce: Essential Ingredients for Optimized Medical Billing Outcomes

December 27, 2023 / admin / Articles, Biling Codes, Billing, Billing AI, Billing Automation, Billing Best Practice, Healthcare Billing, HIPAA, Medical Billing, Medical Billing Ingredients, RCM, Reimbursement, Revenue Cycle Management, Robotic Process Automation, RPA, Secret Sauce
Secret Sauce of Medical Billing

Medical billing sits at the heart of provider revenue cycles, yet few fully appreciate the complexities billing teams navigate to keep financial flows stable. Between interpreting endless payer policies, wrestling with outdated technology, and managing behind-the-scenes patient communications, it takes specialized skills to turn charges into reimbursements. It serves as the financial backbone of the […]

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Healthcare Billing, Healthcare Outcomes, Medical, Medical Billing, Medical Billing Ingredients, Medical Billing Service, Outcomes, Outsourced Billing, Outsourced Medical Billing, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Robotic Process Automation, RPA, Secret Sauce

Getting Paid Faster: Strategies to Improve Cash Flow Cycles

October 16, 2023 / admin / Articles, Billing, Cash Flow Cycles, RCM, RCM Challenges, Reimbursement, Reimbursement Rates, Reimbursement Regulations, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Management (RCM), Revenue Cycle Management Challenges
Billing Cash Flow Cycles

For any medical practice, timely insurance reimbursement is essential for financial viability and supporting smooth practice operations. However, elongated claim payment cycles strain cash flow and necessitate borrowing to cover costs in the interim. Below, we explore techniques to accelerate payer payments and optimize the speed of the medical revenue cycle. Diagnosing Causes of Lagging […]

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Cash Flow Cycles, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, Medical Billing Strategy, RCM, Reimbursement, Reimbursement Rates, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization

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 […]

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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

How Both Healthcare Providers and Medical Billing Companies Succeed

February 3, 2023 / admin / Articles, Billing Best Practice, Claim Status, Claim Status Updates, Healthcare Provider's Expectations, Medical Billing Best Practices, Medical Billing Expectations, Reimbursement, Reimbursement Regulations
Medical Billing Healthcare Provider Handshake

The Business Relationship Between a Healthcare Provider and Medical Billing Company has to be Built on a Solid Foundation What are the Steps in Achieving a Healthy Business Relationship Between a Healthcare Provider and a Medical Billing Company? A good understanding of both sides’ expectations is crucial to the success of both parties. The healthcare […]

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Claim Status Updates, Customer Service, Healthcare, Healthcare Provider's Expectations, Healthcare Providers, Medical Billing, Medical Billing Customer Service, Medical Billing Expectations, Medical Billing Service, Medical Billing Strategy, Medical Claims, Outsourced Billing, Reimbursement, Reimbursement Regulations, Revenue Cycle Management

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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)

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    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

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    Amazon’s Healthcare Revolution: Transforming Patient Care

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  • Group of Ethnically Diverse Medical Doctors Discussing Charge Capture

    Getting Charge Capture Right

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    Value-Based Care Billing: Preparing for the Transition

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