Why is credentialing so slow? After all, doesn’t it seem like you complete an application, submit it and it could be reviewed and approved in a couple of weeks? Let’s take a closer look at the process.

Once upon a time, a practice could forget to get a pre-authorization or maybe exceed the scope or maybe even provide the pre-authorized service on a different day and the carriers would allow for retro-authorizations so the claim would be paid.

Practice owners review many valuable metrics that help monitor the practice’s finances. Some industry experts say the key metric is the clean claims ratio and insist it is essential for real success.

Running a successful practice takes exceptional patient care, outstanding customer service, business acumen and timely accurate billing. You need a team you can count on, and you need a medical billing company that can adapt to the ever-changing healthcare billing landscape.

Historically, most practices were geared toward government and commercial payers for the majority of their collections. However, the shift to greater patient financial responsibility has increased the resources needed in order to collect the money owed to you.

Did you know that claims for services that do not meet the requirements of medical necessity are getting denied instantly? Payers are increasingly more focused on the issue of medical necessity.

Playing the prior authorization game is an art, not a science. There is nothing more frustrating to physicians than knowing a patient needs a certain diagnostic test or medication and having them not be able to get it because their health insurance company won’t cover it.

Extra money - everyone is always interested in how they can make extra money. What if you were offered an extra $30,000, $50,000 or even $100,000 more per year? And, what if you learned you could get the extra money without seeing one more patient?

Employing a non-physician practitioner (NPP) e.g. physician assistant or nurse practitioner has many benefits. It increases patient through-put, enhances the patient experience and increases a practice’s revenue.

You’ve chosen a new medical billing company but now the reality of the transition begins to weigh heavy on you. The first thing to do is work with your new medical billing company to devise a transition plan.