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Is your NPI Registry information up to date?

Have you checked recently to see if your NPI registry information is up to date? Might as well go now to https://npiregistry.cms.hhs.gov/ and just plug in your NPI and verify your information is valid.

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Demystifying the layers of state Medicaid

It can be challenging to understand the many layers of Medicaid plans, the state funded insurance.  Let’s demystify some of these layers. I will explain a little more about three common plan types of state Medicaid. There are more than three types, but for this discussion we will focus on “fee for service”, and CCO […]

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Understanding Prior Authorizations

Understanding Prior Authorizations: Many insurance plans require services to be authorized ahead of time.  After we determine a service requires prior authorization, we will need to determine how to achieve this.  Each plan is unique.  Many accept phone calls, and many require we fill out and submit their own form.  Sometimes there will be a […]

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Two steps to contracting and credentialing

Credentialing a provider with the pay sources (insurances) is a way to let them know who the provider is, and what services are being offered. Medical or behavioral healthcare providers who are intending to get claims paid by insurance companies will want to complete this first step – credentialing. You will need to submit provider […]

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When to Submit Claims

In the debate about when to submit medical claims to pay sources – daily, weekly, or bimonthly, it’s good to think about this as a daily task. While it’s true that many insurances only process payments weekly, if you process and bill claims daily you will be assured a steady income. Also, you will get […]

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