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 […]

Payor Contracting for Providers

Managing payor contracts is one of the main hurdles that every healthcare provider meets. From changing reimbursements to issues accessing networks and managing hidden clauses, contracts represent a significant hurdle that affects every provider, regardless of size. This is why we wanted to share with you the process of Payor Contracting for Providers for you […]

Different Healthcare Provider Contracts

As a healthcare provider, it’s essential to consider your opportunities when considering provider contracts for health care services. Unfortunately, not all provider contracts are created equal. Different types of Healthcare Provider Contracts have major differences in their payment systems that can significantly affect your revenue, the overall success of your facility, and even patient outcomes. […]

Considerations to Private Practice

When smaller, private practices open, it means more competition and a more widespread distribution of profits throughout the industry. It also means that more healthcare providers are granted more autonomy, becoming free to determine their own workflows. Another major byproduct of increasing smaller practices is that they help expand healthcare access to local areas that […]

Health Care Provider Roles

Care Providers are also known as Health Care Providers refer to a person or organization that provides healthcare service to individuals. Many different care providers offer a range of services – from primary and hospital care to diagnostic, rehabilitative, preventative, and palliative care. Health providers play numerous roles in the overall well-being of their patients. […]

Private Practice and Insurance Credentialing

Private Practice and Insurance Credentialing Healthcare providers trying out into private practice often are unsure about establishing their procedures for third-party billing networks for services. The process of billing and reimbursement sometimes refers to as the “Revenue Cycle.” The first step in the revenue cycle is to obtain credentialing and a participating provider contract with […]

Critical Steps for Efficient Provider Credentialing and Enrollment

One of the first steps in medical billing is making sure the provider has been credentialed and enrolled by insurance payers and the Council for Affordable Quality Healthcare (CAQH®). On average, the provider credentialing process can take between 60 to 120 days, so plan early. One mistake during the credentialing process can lead to a […]

Health Care Risk Management

Risk is anything that can result in an unexpected outcome or a loss. You can find risk in just about any industry—the financial sector, transportation, even the health care sector. While all forms of risk can’t be avoided, there is a way they can be managed—through risk management. In the financial industry, you can manage your risks […]