Contracting vs. Credentialing ABA Therapy. What’s the difference? Which Comes First?

Contracting and Credentialing are critical components of any successful medical or psychological practice. It is especially important for small practices and Applied Behavioral Therapy practices. Though understanding the finer points of each, and which one needs to come first requires a little bit of a deep dive into some important details. What Is Credentialing? Credentialing plays a critical role in provider qualifications as well as reimbursement rates. Not to mention the licensing necessary to practice in most communities. It [...]

By |June 30th, 2022|Categories: Tips|Tags: , |0 Comments

Top Credentialing Related Denials & How To Avoid Them

Claim denials are one of the most common causes of inconsistent revenue streams throughout the medical and mental healthcare industries. Not only does it cause delays with incoming revenue, but many require a response to questions, or appeals, which further rob your thriving practice of valuable time that could be better spent treating patients. Of course, this also means that one of the top goals for any competent autism billing company, all healthcare providers, and administrative billing staff is [...]

By |May 3rd, 2022|Categories: Tips|Tags: |0 Comments

Retroactive Reimbursement Requirements For Credentialing

In many states, the law requires carriers to pay for covered services provided to the member during the credentialing process at the in-network benefit level and under the terms of the contract. To apply, the credentialing application must ultimately be approved by the carrier. Credentialing Requirements All health plans are legally required to use a database that is created and maintained by OneHealthPort/Provider Source for credentialing purposes. This includes non-delegated credentialing, where the medical staff services department of a [...]

By |March 6th, 2022|Categories: Tips|Tags: , |0 Comments

What Is Medical Credentialing & How Does It Work?

Medical credentialing is a professional process that helps to establish and maintain effective standards throughout the medical community. Its central goal is to promote patient confidence and ensure the highest quality of care. Though it also plays an important role in verifying a practitioner's license, their education, and streamlining other important information necessary to provide services and work with insurance companies. An organization confirming an individual’s medical credentials will typically contact the certification boards and licensing agencies. This might [...]

By |November 10th, 2020|Categories: Tips|Tags: |0 Comments
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