Main Points

• Be sure to know your credentialing status with each insurance company
   

• Put a financial policy in place for your patient's cost-share amounts
   

• Start to map out your key business processes

Starting our practice is a very exciting venture be...

Main Points

• Timely filing denials occur when the claim is not filed according to the timely filing requirements of the insurance company
   

• Non-covered service denials occur when a provider does not get authorization for a service or a service is flat-out not c...

Main Points

• Your biller needs your EOBs so they can follow up on denials in a timely fashion
   

• Your biller needs your EOBs so they can make sure the insurance companies are paying you what you deserve to be paid
   

• Your biller needs your EOBs so they can...

Main Points

• An aging report is a high-level overview of the outstanding money owed to a practice
   

• It is useful because it gives you a picture of the health of a practices processes

Accounts Receivable (A/R) is the money owed to your practice by patients and...

Main Points: 

• What is a CMS 1500 Form
   

• What do all the boxes mean

In the United States Healthcare system there are actually two types of claim forms. There is a CMS 1500 form and a UB-04 form. The claim form system was developed to help identify the procedu...

This post describes how to get on a closed panel

Main Points

• It is not always easier to add providers to a group
   

• Limited-license providers are tricky and depend on states rights
   

• Benefits for raise increases as a group vs. individual

Perhaps you are growing a group practice or are just starting ou...

Main Points

• What is credentialing
   

• What are the steps in credentialing 
   

• What are the pitfalls to avoid

Next, you will need to understand the basic process for credentialing in order to apply the terms you have learned above. Here are some frequently...

Main Points

• Terms
  
   

• The complete list of information you will need to credential with insurance companies

Navigating credentialing is a lot like wading through concrete. It can be a long and slow process, but there are actions you can take in order to be a...

Main Points

• Be Clear
   

• Be Concise
   

• Be Constructive

The reality of high deductible health plans (HDHPs) is still setting in. Patients are choosing to pay less in monthly premiums in exchange for HDHPs, but this places more of the financial burdens on t...