Good Things To Know About Credentialing

There’s a lot of information to know about credentialing, and sometimes it can be confusing. You can always expect changes in the process or variations among payers or insurance companies. These changes would many times cause interruptions in a practice’s reimbursements and the whole revenue cycle. And because of that, it is quite important to […]

Provider Enrollment Specialist: What They Do, Responsibilities and Skills

A provider enrollment specialist is responsible for the enrollment of providers in the healthcare system. They work with both providers and insurance companies to ensure that all paperwork is completed correctly and that providers are able to be seen by patients. In doing so, the specialist is also responsible for ensuring adherence to HIPAA guidelines […]

Credentialing and Payer Enrollment Services

Provider enrollment and credentialing were overlooked as an important component of healthcare management practices for years. While they seemed to be tedious processes to go through, they’re quite necessary for a provider to receive in-network reimbursement from payers. Their impact on compliance issues and financial aspects of a specific practice has guaranteed that these are […]

CAQH: Definition, Explanation, Importance

Council For Affordable Quality Healthcare Defined And Explained CAQH: The Council Defined CAQH, or the Council for Affordable Quality Healthcare, is a non-profit organization of national healthcare networks and plan providers whose objective is to improve the quality of healthcare and its accessibility. It’s primarily designed for providers and their staff in order to eliminate […]