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Posts tagged "Contract Management"

Provider Challenges in Payer Contracting

November 4, 2025 / admin / Articles, Contract Analysis, Contract Management, Contract Negotiations, Contracting, Contracting AI, Payer Contract, Payer Contract Analysis, Payer Contract Management, Payer Contracting, Payer Contracts
A Group of Contracted Doctors Standing in Times Square

Healthcare providers face constant battles when negotiating and managing contracts with insurance companies. These obstacles affect every type of practice, from solo physicians to massive hospital networks. The difficulties come from unequal bargaining power, hidden information, endless paperwork, and the overwhelming number of different insurance companies in the market. For most providers, dealing with payer […]

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Contract Analysis, Contract Management, Contract Negotiations, Contracting, Contracting AI, Payer Contract, Payer Contract Analysis, Payer Contract Management, Payer Contracting, Payer Contracts

Why Providers Need Both Credentialing and Contracting

October 1, 2025 / admin / Articles, Contract Management, Contract Negotiation, Contracting, Credentialing, Credentialing and Contracting, Medical Credentialing, Payer Contract, Payer Contract Management, Payer Contracting, Payor Contract, Payor Contracting
A White, Male Medical Doctor Signing Paperwork. Sitting at a desk.

Healthcare providers often view credentialing and contracting as separate administrative hurdles they must clear to start practicing. While these processes might seem distinct on the surface, they’re actually two sides of the same coin, both essential components of establishing a viable healthcare practice. Knowing why both are necessary, and how they work together, can save […]

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Contract Management, Contract Negotiation, Contracting, Credentialing, Credentialing and Contracting, Medical Credentialing, Payer Contract, Payer Contracting, Payor Contract, Payor Contracting

Key Performance Indicators That Drive Payer Contract Decisions

January 31, 2025 / admin / Articles, Contract Management, Payer Contract, Payer Contract Negotiation, Payer Contracting, Payer Contracts, Payer Negotiation, Payer Regulations, Payor Contract, Payor Contracting
Group of diverse medical doctors in scrubs, smiling

Healthcare payers operate in a data-rich environment where every contract decision can impact millions of dollars in claims, member satisfaction, and regulatory compliance. The metrics that guide these decisions go far beyond simple cost considerations, encompassing quality outcomes, network adequacy, and member experience factors that directly influence an organization’s competitive position and financial health. Smart […]

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Contract Management, Payer Contract, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Payer Regulations, Payor Contract, Payor Contracting

Recent Posts

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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

  • Primary Care Medical Billing, Credentialing

    Which CPT Codes are Used in Primary Care Billing

  • A Group of Contracted Doctors Standing in Times Square

    Provider Challenges in Payer Contracting

  • White Female Master Medical Credentialing Expert

    Complete Credentialing and Enrollment Process for Providers

  • Aging Asian-American Female Medical Doctor

    Use Case: Behavioral Health Credentialing

  • AI Bot Assistance in Medical Credentialing

    How Does AI Assist Medical Credentialing?

  • Medical Credentialing Specialist Resume

    How to Write a Medical Credentialing Specialist Resume

  • 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

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