May 28, 2019

Insurance Credentialing 101

Insurance credentialing, often times referred to as provider enrollment, is the process of becoming affiliated with an insurance company as an in-network/participating provider.  Accurate credentialing and enrollment is a critical part of starting and maintaining a medical practice to receive payment for services rendered.  Mistakes and/or omissions will result in lost revenue, or at the very least, delayed reimbursement.  It is important to understand the credentialing terminology commonly used.

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