by Advantum Health | Feb 11, 2020 | MACRA Solutions
In April 2015, Congress eliminated the SGR (Sustainable Growth Rate) — the formula used to calculate Medicare payments to healthcare providers. In its vacancy came the newly proposed Quality Payment Program and MACRA (Medicare Access and CHIP Reauthorization Act of...
by Advantum Health | Feb 11, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
As a physician or other healthcare provider, you must apply for initial medical credentialing and be re-credentialed every 2-3 years, depending on the state in which you live and the policies of your payers. It’s a monumental task, but a necessary one, as...
by Advantum Health | Feb 11, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
Medical credentialing is an in-depth and meticulous process. The standards set forth by regulatory bodies like the National Committee for Quality Assurance (NCQA) require preliminary and ongoing review of a healthcare provider’s qualifications. These include, but are...
by Advantum Health | Feb 11, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
If your medical credentialing is still being done with filing cabinets, paper, spreadsheets, email, and fax, upgrading to medical credentialing software or a total outsourcing solution will save time and effort and increase the accuracy of your credentialing. The long...
by Advantum Health | Feb 11, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
In healthcare, Physician Credentialing is the process of organizing and verifying a doctor’s professional records. This includes their board certifications, hospital admitting privileges, education, insurance, professional references, work history, and more....
by Advantum Health | Jan 29, 2020 | Revenue Cycle Management Solutions
One of the most common errors in medical billing and denied claims is an incorrect or missing NPI number. Insurance claims submitted to Medicare, Medicaid or any health plan are not paid without an accurate NPI. An NPI number, known as a National Provider Identifier,...
by Advantum Health | Jan 24, 2020 | Revenue Cycle Management Solutions
Healthcare is a challenging and constantly changing field, and for those who work in upper management, such as hospital administrators, CEO’s, CFO’s, or CTO’s, navigating this complex arena is part and parcel of the job. One of the most challenging aspects of being in...
by Advantum Health | Jan 23, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
Medical credentialing and hospital privileging are both pertinent processes for physicians and other medical staff that ensure the quality care of patients and proper delivery of medical treatment from qualified practitioners. So as not to confuse the two, medical...
by Advantum Health | Jan 23, 2020 | Medical Credentialing
Medical credentialing is a time-consuming and complicated process that if not done accurately can cost hospitals valuable time and money. While verifying a provider’s credentials doesn’t sound all that difficult, there are tons of problems and mistakes that can slow...
by Advantum Health | Jan 23, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
Medical credentialing for hospitals and healthcare practices can be a time-consuming and expensive process. At hospitals, credentialing professionals deal with countless physicians and other healthcare providers who deliver healthcare services, and it can take an...
