Individual vs. Group Credentialing

Medical credentialing ensures that a physician both has the proper education to perform their services and is “in-network” with health insurance companies. As such, the credentialing process involves collecting and evaluating all available data on a physician in order to ensure their credentials. While you can credential individuals, you can also credential people as a… Read more »

Medical Billing Issues That Are Impacting Your Practice

Every practice needs to have a medical billing system set up in order to properly receive payments in a timely manner. Many struggle with problems regarding their medical billing procedures. Here we identify some of the common medical billing issues practices. Failure to notify patients of financial obligations As we’ve discussed in previous blog posts,… Read more »

4 Ways to Collect Outstanding Patient Balances

In recent years, patients have become increasingly responsible for their medical costs. This means that they’re paying more out-of-pocket for procedures than they did even ten years ago. While some patients can handle this, others struggle to cope with this extra financial burden. This causes many to have outstanding patient balances which can be a… Read more »

The Pros and Cons of Credit Card on File

With patients paying more and more of their medical costs, many physicians across the country are looking for ways to ensure patients pay their bills in a timely manner. Keeping a patient’s credit card on file is one of these ways. There are several advantages to this form of payment, but also some disadvantages that… Read more »

What is Revenue Cycle Management?

One of the most crucial aspects of managing a medical practice is to ensure that the finances are in order, something that is critical for being able to maintain the operation of the medical practice. Revenue cycle management (RCM) is another terminology for Accounts Receivable, or the collection of insurance carrier and patient payments which… Read more »

Common Questions About Medical Credentialing

Medical credentialing and contracting is required for a provider to receive payment for their services. Medical credentialing is a complicated process that takes time and precision. There are many steps and doing just one thing incorrectly can upend the process. Here are some of the most commonly asked questions about medical credentialing: How long does… Read more »

What is Medical Credentialing?

Ensuring a healthcare provider has the proper education, training, certification and credentials not only makes certain that they are qualified to provide care, but it is also integral to being “in-network” with health insurance companies. Credentialing makes this happen. But what is it and how, exactly, does it work? Here are the details: Credentialing—The Basics… Read more »

Medical Revenue: Planning Your Service Charges with the Medicare Physician Fee Schedule in Mind

The Medicare Physician Fee Schedule (MPFS) applies to healthcare provider services such as office visits, lab work, types of therapy, surgical procedures and more. It gives providers guidelines on what Medicare will cover for services and how much it will reimburse the provider. Medicare Physician Fee Schedule Rates The rates are determined based on input… Read more »

Credentialing Services: Adding or Removing a Physician from Your Carrier Profiles

Being a practice within a managed care carrier network or multiple carrier networks means inevitably having to add or remove a physician from your carrier profile. This process involves an application process (completing the 30-page Council for Affordable Quality Healthcare (CAQH) questionnaire) for a specific network and must be completed whenever there is a provider… Read more »

Credentialing Services: Benefits of Joining a Carrier Network

Taking the time to join an established provider network can sound like a huge drain on office resources but doing so can be a major benefit for healthcare providers in the practice, as well as your patients. In-network vs. out-of-network Most patients with insurance have the option of choosing a doctor or healthcare provider that… Read more »