More dental practices are billing medical plans today than ever before. This is due to the crossover of several procedures that are medically necessary yet require a licensed dentist to perform. Most notably is the oral appliance to treat obstructive
Thanksgiving Activities – STAT! If the Healthcare Field wasn’t already busy enough, we’re headed into the busy-ness of the holidays too. If you’re hosting a family thanksgiving, consider it an opportunity to create a fun family environment that helps
Top Changes to Provider Enrollment You Should Know About
The changes in payor enrollment for 2017-2018 have been revealed and it seems that mid-level practitioners, independent nurse, and occupational and physical therapists will be affected the most. The amendments were proposed in April of this year and are
A Sound Credentialing Program is Like a Well-Designed Building
By Dilsa S. Bailey, CPMSM Architects first get a view of the land. Before they envision a building, they envision what would fit into that landscape. The architect then considers what occupies the surrounding space. It is then they start
Put down the pen and paper: It’s Time to go digital with credentialing & provider enrollment!
As more and more practices are employing providers, medical credentialing and provider enrollment have become THE priority in revenue cycle management! Enrolling providers correctly and quickly is the most important step in getting providers in-network with insurance plans. The quicker
Have You Ever Renegotiated Your Payor Contract & Fee Schedules?
Have you ever wondered if renegotiating contracts is really worth the time and effort? Is an increase in payment even possible? Will payers consider changing your contracted rates? According to The American Medical Association, doctors are working harder and earning less.
10 Key Considerations: Outsourcing Credentialing, Enrollment and Contracting
An increase in the number of closed networks and reimbursement changes are just two of the factors making the credentialing, payor enrollment, and contracting processes more complex and more time consuming. Small healthcare organizations could certainly manage these processes in-house if they have the money, expertise and staff. However, large healthcare organizations,
The Importance of CAQH
An important aspect of provider enrollment and credentialing is CAQH set up and maintenance. With rising healthcare costs, enrolling in CAQH can help relieve some of the healthcare administrative costs. A benefit of enrolling in the CAQH database/registry is having
Benefits of Outsourcing Credentialing and Payor Provider Enrollment
Just a few years ago, healthcare professionals considered payor enrollment to be optional for building their practice. Today, it has become more necessary than ever for providers to be in-network with insurance companies. This is partly because more people in
Top 5 Provider Enrollment Mistakes
Provider enrollment, or payor enrollment, refers to the process of applying to health insurance networks for inclusion into their provider panels. For commercial insurance panels, this process involves two steps; (1) credentialing and (2) contracting. For government plans, i.e., Medicare,