Setting up a dental practice isn’t just about finding the right exam chairs or putting together a great team. These days, where insurance matters and regulations keep changing, one of the most important steps every dental office needs to tackle is dental credentialing. If that term sounds a bit technical, think of it this way:...
When it comes to healthcare, one of the most important things for a provider’s business is called “payer contracting.” Think of it as the handshake deal between a doctor or a hospital and an insurance company. These contracts aren’t just a bunch of boring legal papers; they’re super important because they decide what services get...
Getting a healthcare provider “onboarded” isn’t as simple as just hiring them and handing over a patient list. Two separate but equally essential steps—credentialing and payer (provider) enrollment—need to happen before a clinician can see patients and get paid for their work. While they often happen side by side, each step serves a unique purpose and...
Many healthcare organizations mix up provider credentialing and provider enrollment, even though they are two separate steps. Credentialing checks a provider’s qualifications, while enrollment gets them approved to join insurance networks and get paid. Knowing the difference helps avoid delays and makes starting work much easier. This article explains what credentialing and enrollment are, why...
Imagine you’re running a healthcare practice. Your busy clinic hires a qualified new doctor. Patients are eager to book appointments, but the doctor’s credentialing isn’t finished yet. Now, you’re left wondering—can the doctor see patients before everything is approved? What risks and rules do you need to watch out for? In this article, we’ll explore...
Medical credentialing is the process healthcare organisations use to verify a provider’s qualifications, such as education, training, licenses, certifications, and work history, before allowing them to deliver patient care. This step makes sure that only qualified professionals can practice, protecting patient safety and a facility’s reputation. Complete and accurate documentation is important for a smooth...
Primary Source Verification (PSV) is an essential process in healthcare that helps confirm a provider’s qualifications and credentials directly from the original issuing source. This means that organisations do not just rely on copies of certificates or reported information by the provider; every degree, license, and certification is checked with the authority that issued it....
If you are a healthcare provider, you have likely come across the term “NPI number” during your career. But what exactly is an NPI number, and why is it so important? NPI numbers may seem like just another box to check on paperwork, but they actually play an important role in keeping the healthcare system...
In healthcare, time is often the difference between serving patients and waiting on the sidelines. For doctors, nurses, and other providers, one important step before they can begin treating patients or billing insurance is credentialing. Credentialing is the process that verifies a provider’s qualifications — including their education, training, licenses, work history, and any disciplinary...
Medical insurance credentialing is a must-do step in the healthcare system in the USA. It’s an important process that lets most healthcare providers join insurance networks and get paid for the care they give. If this process is delayed or done wrong, it can cause big money problems. A healthcare practice can lose a lot...