Blogs
We stay up to date on the ever-changing insurance market's impacts on your specialty for you...because it's basically a full time job in and of itself.
CC Services QA: Your No-Nonsense Guide to Payer Contracting
CC Services QA: Your No-Nonsense Guide to Payer Contracting Where Do I Start? Let’s start with your strategy. We have to decide who you want to get in-network with and why! Should I Take Medicare? Medicare is a major government payer serving largely the 65+ age range. So, if you’re serving a population even partially […]
Stop Billing Like a 1099 in 1999: The Right Way to Set Up Insurance Contracts (EIN, GNPI, INPI & More)
Stop Billing Like a 1099 in 1999: The Right Way to Set Up Insurance Contracts (EIN, GNPI, INPI & More) Let’s talk about a tale as old as time. A well-meaning provider launches a practice, gets credentialed under their Social Security Number (SSN) and individual NPI (INPI)… or, equally messy, their SSN with their group […]
OPTING OUT OF MEDICARE – WHAT DO I NEED TO KNOW?
OPTING OUT OF MEDICARE – WHAT DO I NEED TO KNOW? All Medicare beneficiaries have the right to choose their own doctors and other healthcare providers. But if you are a physician who has opted out of the Medicare program, there are a few things you should know. First of all, what does it mean to opt […]
The Most Important Step in Contracting and Credentialing…
What’s the top priority: The Application or the Follow Up? Riddle me this: What is more important in any paperwork submission process: 1) The initial application itself? 2) The follow up work? Of course, the application should be complete with 100% accuracy, this is critical. In the medical insurance contracting and credentialing world, however, the […]
Credentialing and Contracting in Medical Billing: What it is and Why it Matters
Your practice sees it happen daily: would-be new patients call or stop by your practice, hoping to set an appointment, having been referred to you by a friend or a loved one. They’ve heard you’re the best in town, and are ready to set that initial consultation. At the last moment, they discover your practice is not in network for their insurance. Yet another prospective patient is shown the door.
What exactly does it mean to be ‘in network’? What is credentialing in medical billing, anyway, and do physicians complete this process? In this post, we’ll deep dive into the topic of credentialing to illuminate confusing areas and provide information vital to submitting your applications and negotiating your next partnership contract.
Understanding and Communicating Your Network Status
How do I know if I am in network with my patient’s insurance plan? Simple question with a not so simple answer…
