Billing & Credentialing Cranberry Twp. (Pittsburgh)
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  • Value Based Care

Value Based Care

Value-Based Care Billing: Preparing for the Transition

September 20, 2025 / admin / Articles, RCM, Value Based Care, Value Based System, Value-Based, Value-Based Care, Value-Based Care Adoption, Value-Based Care Integration, Value-Based Care Models, Value-Based Models, Value-Based Reimbursement
Caucasian Red-Headed Male Medical Doctor

The healthcare industry stands at a pivotal moment. After decades of fee-for-service models that prioritized volume over outcomes, we’re witnessing a fundamental shift toward value-based care arrangements that reward quality, efficiency, and patient satisfaction. This transformation is reshaping the entire financial foundation of medical practices. For healthcare providers, this transition represents both tremendous opportunity and […]

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RCM, Value Based Care, Value Based System, Value-Based, Value-Based Care Adoption, Value-Based Care Integration, Value-Based Care Models, Value-Based Models, Value-based Reimbursement

Payer Contract Optimization Strategies

September 16, 2025 / admin / Articles, Healthcare Rate Negotiations, Medical Rate Negotiations, Payer Relationships, Rate Negotiations, Value Based Care, Value-Based, Value-Based Care, Value-Based Care Adoption, Value-Based Care Integration, Value-Based Models
Payer Contracting Negotiation

Managing payer contracts effectively can make the difference between a thriving practice and one that struggles financially. Healthcare organizations face mounting pressure to maximize revenue while delivering quality care, and optimizing payer contracts sits at the heart of this challenge. Smart contract optimization is about creating sustainable partnerships that benefit both providers and payers while […]

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Healthcare Rate Negotiations, Medical Rate Negotiations, Payer Relationships, Rate Negotiations, Value Based Care, Value-Based, Value-Based Care Adoption, Value-Based Care Integration, Value-Based Models

Value-Based Care: What It Is and Why You Should Care

August 23, 2025 / admin / Articles, Value Based Care, Value Based System, Value-Based, Value-Based Care, Value-Based Care Adoption, Value-Based Care Models, Value-Based Models, Value-Based Pricing, Value-Based Reimbursement, VBC
Value-Based Care Models

Healthcare in America is undergoing a fundamental transformation. For decades, our medical system operated on a simple premise: the more services provided, the more money earned. This fee-for-service model incentivized volume over value, leading to escalating costs, fragmented care, and outcomes that often failed to match the enormous investment. Enter value-based care, a revolutionary approach […]

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Value Based Care, Value Based System, Value-Based, Value-Based Care Adoption, Value-Based Care Models, Value-Based Models, Value-Based Pricing, Value-based Reimbursement, VBC

The Impact of Value-Based Care on Credentialing Requirements

November 8, 2024 / admin / Articles, Credentialing, Credentialing Criteria, Recredentialing, Value Based Care, Value Based System, Value-Based, Value-Based Care, Value-Based Care Adoption, Value-Based Care Models, Value-Based Models
Value-Based Care Models

The healthcare landscape is undergoing a seismic shift. Gone are the days when healthcare providers could simply bill for services rendered and expect payment based on volume alone. Welcome to the era of value-based care (VBC), where compensation is increasingly tied to quality outcomes and patient satisfaction. This transformation isn’t just affecting how care is […]

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Credentialing, Credentialing Criteria, credentialing on-boarding, Recredentialing, Value Based Care, Value Based System, Value-Based, Value-Based Care Adoption, Value-Based Care Models, Value-Based Models

Value-Based Care: Transforming Healthcare Delivery and Outcomes

September 16, 2024 / admin / Articles, Value Based Care, Value Based System, Value-Based, Value-Based Care, Value-Based Care Adoption, Value-Based Care Models, Value-Based Models, Value-Based Pricing
Value-Based Care Billing w/ Smiling Medical Doctors

The healthcare industry is undergoing a significant transformation, shifting from traditional fee-for-service models to a more patient-centric, outcome-focused approach known as Value-Based Care (VBC). This paradigm shift represents a fundamental change in how healthcare is delivered, measured, and reimbursed. Value-Based Care aims to improve patient outcomes while simultaneously reducing healthcare costs, creating a win-win situation […]

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Value Based Care, Value Based System, Value-Based, Value-Based Care Adoption, Value-Based Care Models, Value-Based Models, Value-Based Pricing

Medical Billing Trends in Healthcare

September 8, 2024 / admin / AI, AI Models, AI RCM, AI-driven RCM, Articles, Artificial Intelligence, Cybersecurity, Interoperability, Medical Billing Trends, Patient-Centric, Patient-Friendly, Telehealth, Telehealth Billing, Transparency, Value Based Care, Value-Based, Value-Based Care Models
Medical Billing Resources

Medical billing stands as a critical component that continues to evolve rapidly. As we progress through 2024 and beyond, the landscape of medical billing is being reshaped by technological advancements, regulatory changes, and shifting patient expectations. We’ll inspect the current trends that are transforming the medical billing industry, their implications for healthcare providers and patients, […]

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AI, AI Models, AI RCM, AI-driven RCM, Artificial Intelligence, Cybersecurity, Interoperability, Medical Billing Trends, Patient-Centric, Patient-Friendly, Telehealth, Telehealth Billing, Transparency, Value Based Care, Value-Based, Value-Based Care Models

Understanding the Latest Healthcare Regulatory Changes Impacting RCM

March 8, 2024 / admin / Affordable Care Act, Articles, Coding and Documentation, Cybersecurity, Data Privacy, Health Equity, Interoperability, Non-Discrimination Regulations, Price Transparency, RCM, Regulatory Changes, Regulatory Compliance, Regulatory Requirements, Revenue Cycle Management, Telehealth, Value Based Care, Virtual Care Regulations
RCM Product Managers

The healthcare industry is dynamic, and staying up-to-date with the latest regulatory changes is crucial for efficient Revenue Cycle Management (RCM). RCM encompasses the processes involved in tracking and collecting patient service revenue, from the initial registration and appointment scheduling to the final payment of balances. Failure to comply with regulatory requirements can result in […]

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Affordable Care Act, Coding and Documentation, Cybersecurity, Data Privacy, Environmental Sustainability, Health Equity, HIPAA, Interoperability, No Surprises Act, Non-Discrimination Regulations, Patient Access, Price Transparency, Regulatory Changes, Regulatory Compliance, Regulatory Requirements, Telehealth, Value Based Care, Virtual Care Regulations

Essentials of Revenue Optimization in Healthcare

March 4, 2024 / admin / Articles, Better Payer Contracts, Billing, Clinical Documentation, Patient Collections, Renegotiate Payer Contracts, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Revenue Integrity, Revenue Leakage, Revenue Optimization, Value Based Care, Value-Based Care, Value-Based Models
Revenue Cycle Management Coins

The healthcare industry is undergoing massive changes. With rising costs, declining reimbursements, and shift towards value-based care, healthcare providers face significant financial pressures. At the same time, patients demand superior access, quality, and lower out-of-pocket costs. To thrive in this environment, healthcare organizations must adopt a strategic approach to revenue optimization. Revenue optimization involves systematically […]

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Better Payer Contracts, Billing, Clinical Documentation, Healthcare, Healthcare Billing, Medical, Medical Billing, Patient Payments, RCM, Renegotiate Payer Contracts, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Revenue Integrity, Revenue Optimization, Value Based Care, Value Based System

Why HCC Coding is Crucial for Medical Providers

April 22, 2023 / admin / Articles, Chronic Care Management, HCC, HCC Coding, Hierarchical Condition Category, Population Health Management, Value Based Care, Value Based System
hcc-coding-white-male-doctor-at-laptop-medical-billing

Healthcare is a constantly evolving industry, and medical practices need to keep up with the changes to provide high-quality patient care. One of the significant changes in the healthcare industry is the transition from fee-for-service to value-based care. As a result, medical providers need to focus on accurate and complete documentation of patient encounters to […]

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Chronic Care Management, HCC, HCC Coding, Hierarchical Condition Category, Population Health Management, Value Based Care

The Benefits and Challenges of Adopting Value-Based Care

March 19, 2023 / admin / Articles, EHR, Healthcare, HIPAA, Medical, Value Based Care, Value Based System, Value-Based, Value-Based Care, Value-Based Care Adoption, Value-Based Care Models, Value-Based Models, Value-Based Pricing, VBC
Doctors Adopting Value-Based Care

Value-based care (VBC) is a healthcare delivery model that aims to achieve better health outcomes and cost-effectiveness by focusing on the value of care provided to patients. This model shifts the focus from the traditional fee-for-service approach, where healthcare providers are paid based on the number of services they provide, to a system where providers […]

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EHR, Healthcare, Healthcare Outcomes, HIPAA, Medical, Value Based Care, Value Based System, Value-Based, Value-Based Care Adoption, Value-Based Care Models, Value-Based Models, Value-Based Pricing, VBC

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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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