INSIGHTS

What is a Payer in Healthcare?

What is a Payer in Healthcare?

Payer contracts in healthcare are vital, as they dictate the terms and conditions for medical services, coverage, and payment, between healthcare providers and payers. They are of high importance for your medical practice’s revenue and are the foundation of our healthcare system. Payers in the healthcare area are the different organizations, such...

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What Is the Purpose of Credentialing?

What Is the Purpose of Credentialing?

Most practices are not equipped to handle the basic provider enrollment or contracting needs of today’s healthcare environment. If you are a new start-up practice, we can help get you on the right track from the beginning. The credentialing process and payer enrollment will ensure that you are ready to begin your practice. From starting your...

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Is Revenue Cycle Management Important in Healthcare?

Is Revenue Cycle Management Important in Healthcare?

An effective process of revenue cycle management involves the coordination and optimization of various processes, from patient registration and billing to claims submission and reimbursement. Revenue cycle management ensures that healthcare providers receive timely and accurate payments for the services they provide, and it is crucial for the...

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What Are the Three Main Types of Credentialing?

What Are the Three Main Types of Credentialing?

Credentialing plays a vital role in ensuring that healthcare providers meet specific standards of competence and quality. It is the process of verifying and evaluating the qualifications, experience, and professional background of healthcare professionals. Credentialing is crucial for maintaining patient safety and facilitating the provider's...

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Why is credentialing important for medical assistants?

Why is credentialing important for medical assistants?

The healthcare industry is one of the most regulated sectors in the United States, and healthcare providers must comply with a plethora of regulations and standards to ensure the safety and well-being of their patients. Medical assistants, who play a critical role in the healthcare delivery system, are no exception. Credentialing is an essential...

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What is the Role of a Consultant in Healthcare?

What is the Role of a Consultant in Healthcare?

The healthcare industry is constantly evolving, and healthcare providers must stay up-to-date with the latest developments to provide high-quality care to their patients. However, with the ever-changing landscape of healthcare, it can be challenging for providers to keep up with the latest trends and best practices. This is where a healthcare...

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What is revenue cycle management in medical billing?

What is revenue cycle management in medical billing?

As a healthcare provider in Houston, Texas, managing the revenue cycle can be a complex and challenging process. Revenue cycle management (RCM) is the process of managing the financial aspects of patient care, from verifying patient eligibility and collecting copayments to submitting claims and following up on payments. Effective RCM is critical...

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How can a healthcare organization improve its revenue cycle management?

How can a healthcare organization improve its revenue cycle management?

Revenue cycle management (RCM) is the process of managing the financial aspects of patient care, from verifying patient eligibility and collecting copayments to submitting claims and following up on payments.  Effective RCM is critical to maintaining the financial health of healthcare organizations in Houston, Texas, and ensuring they can...

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What Is a Healthy Managed Care Payer Mix?

What Is a Healthy Managed Care Payer Mix?

A healthy payer mix is a vital metric for your medical practice because it affects the revenue stream and your bottom line. Every healthcare institution should track the payer mix and manage it carefully to adjust to the changing demands of the market. Read on to discover what a payer mix is, what a healthy managed payer mix looks like, and how...

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Can Automated Procedures Help Maximize Reimbursement?

Can Automated Procedures Help Maximize Reimbursement?

A strategic revenue cycle management is vital for maximizing your reimbursement and ensuring the good financial well-being of your practice. However, it is a complex process with many opportunities for potential issues. That’s why healthcare administrators and other professionals have developed various automated procedures to help streamline...

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In-Network vs. Out-of-Network: What’s the Difference?

In-Network vs. Out-of-Network: What’s the Difference?

Patients who come to your practice have one of many available health insurance plans. If you have signed a contract with a specific payor, your practice is in-network for people with an insurance plan from that payor. However, different insurance plans also determine whether the patients receive coverage for visiting in-network or out-of-network...

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What Are the Types of Healthcare Consulting

What Are the Types of Healthcare Consulting

The healthcare industry is complex, and practice owners need help navigating through the changing landscape of the industry. It’s impossible to keep track of all the laws, regulations, policies, new medications, and procedures while still being able to run and manage a practice and attend to your patients. Luckily, healthcare consulting can make...

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How Digital Marketing Can Help With Client Satisfaction

How Digital Marketing Can Help With Client Satisfaction

Digital marketing has become crucial for the success of many healthcare practices. It can help attract more patients, build a stronger relationship with them, and improve their satisfaction. Most of all, digital marketing helps medical professionals and practices thrive in today’s highly competitive healthcare industry. Read on to discover how to...

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Why is Digital Marketing Important in Healthcare?

Why is Digital Marketing Important in Healthcare?

The Healthcare industry has become more competitive than ever. That’s why healthcare professionals and practices use different tools to gain an edge over their competition. For example, digital marketing is one of the most popular approaches, because it's one of the best ways to spread awareness about your medical services and attract more...

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Get Your Front Office Ready for January

Get Your Front Office Ready for January

Make sure all Front Office Staff is prepared for January 2023. Each of these steps will help avoid issues within the Revenue Cycle.Patient Demographics Update: Verify patient address, phone number, email address and emergency contact information Verify Referring and/or PCP Information Verify ABN on file, if necessary Obtain new copies of driver...

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How Contracting Can Help You Maximize Reimbursement

How Contracting Can Help You Maximize Reimbursement

Contracting is vital for any medical institution because it determines the type of relationship and reimbursement structure a practice can receive from the payer. It explains provider benefits, credentialing, medical necessities, reimbursement rates, schedules, and other things crucial for your medical practice. Read on to learn how to leverage...

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Three Steps to Maximize Your Reimbursement

Three Steps to Maximize Your Reimbursement

The goal of any healthcare practice is to provide excellent patient care. To do that, you must optimize your revenue cycle and increase your medical billing efficiency. Here you can discover the three most important steps to maximize reimbursement and improve your practice’s financial well-being. Improve Claim Management The insurance providers...

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What Are the 5 P’s of Healthcare Digital Marketing?

What Are the 5 P’s of Healthcare Digital Marketing?

The five P’s of healthcare digital marketing represent a strong base on which you can build your advertising strategy. Discover the five P’s of healthcare marketing and how they can help your medical practice. Patients Today’s patients are more interested in their health, but they are also bombarded with different information from all sides....

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5 Ways to Negotiate Payer Contracts

5 Ways to Negotiate Payer Contracts

Payer contracts are vital for your medical practice’s revenue and are the foundation of our healthcare system. Negotiating a more favorable payer contract will help you improve your income potential, allowing you to provide better care to your patients. However, payers don’t necessarily reward loyalty with better payer contracts. That’s why you...

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How to Ensure a Successful Healthcare Credentialing Process

How to Ensure a Successful Healthcare Credentialing Process

The healthcare credentialing process is vital for establishing frameworks and guidelines, and confirming that medical providers are competent to care for their patients. Every time a medical facility employs a new physician, nurse, or another healthcare practitioner, they must go through the medical credentialing process to verify their...

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Office Closure: Labor Day

Office Closure: Labor Day

Office Closure: Labor DayLet’s Connect Please complete the information below to receive a complimentary practice analysis or more information on a specific service.

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What Is a Managed Care Contract?

What Is a Managed Care Contract?

What Is a Managed Care Contract?A managed care contract is an agreement between a medical facility and an insurance company to provide patient care while the latter covers the cost of these services. Managed care contracts are how things work in the US healthcare system and what makes medical services more affordable to people. When signing a...

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What’s the Difference Between Payer Enrollment and Credentialing?

What’s the Difference Between Payer Enrollment and Credentialing?

What’s the Difference Between Payer Enrollment and Credentialing?Healthcare management is a complex field that requires special training and continuous education for the best results. Unfortunately, some new medical practices struggle to keep up with rules and regulations, and they often struggle to understand the difference between specific...

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Office Closure: Labor Day

What Are the Types of Freestanding and Hospital-Based Ambulatory Care Services?

What Are the Types of Freestanding and Hospital-Based Ambulatory Care Services? Ambulatory care refers to diagnostic, preventative, and treatment services people receive in a facility and depart within the same day. This facility can be freestanding or connected to another medical practice, most commonly a hospital. Ambulatory care has evolved...

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How Common Are Medical Billing Errors in Medical Claims?

How Common Are Medical Billing Errors in Medical Claims?

How Common Are Medical Billing Errors in Medical Claims? People tend to get anxious every time they have to open a medical bill. Considering the state of the US healthcare system, the medical bills often run in 5, 6, or even 7 figures. And there is a big question if your insurance is going to cover everything. People assume that healthcare...

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What Is Credentialing in Healthcare?

What Is Credentialing in Healthcare?

What Is Credentialing in Healthcare? Not everyone can be a medical provider. You need to hold specific degrees, training, certifications, and other proof that you are able to practice medicine. Credentialing is a process that verifies you are competent and trained to provide care to patients seeking medical assistance. Credentialing also...

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What Are the Office-Based Surgery Guidelines?

What Are the Office-Based Surgery Guidelines?

What Are the Office-Based Surgery Guidelines? As healthcare moves from traditional inpatient facilities like hospitals to outpatient settings, we observed a significant rise in office-based surgery procedures. Good regulation in this field was vital to prevent adverse effects and minimize the chances of negative health outcomes. An advance in...

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What Type of Medical Practice Has the Greatest Shortage of Physicians?

What Type of Medical Practice Has the Greatest Shortage of Physicians?

What Type of Medical Practice Has the Greatest Shortage of Physicians? Physician shortages have been affecting America’s healthcare for decades. It is a widespread problem and contributes to limited patient access, worse patient care, increased physician burnout, and other issues. The alarming thing is that the demand for physicians is only...

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What Is Payer Enrollment?

What Is Payer Enrollment?

What Is Payer Enrollment? Payer enrollment is the essential step in the revenue cycle of any healthcare organization. It refers to the process of joining a health insurance network, intending to be included in their provider plans.  However, many people underestimate just how complex and time-consuming this process can be. Inexperienced staff may...

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Which Patients Are More Likely to Engage With Your Medical Practice

Which Patients Are More Likely to Engage With Your Medical Practice

Which Patients Are More Likely to Engage With Your Medical PracticeWhich Patients Are More Likely to Engage in Their Care? Patient engagement has become the main focus of modern healthcare. When healthcare practitioners manage to engage patients in their care, they are more likely to feel optimistic about the treatment, have higher self-esteem,...

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Best Revenue Cycle Management Tools

Best Revenue Cycle Management Tools

Best Revenue Cycle Management Tools Good revenue cycle management is vital if you want to ensure your income stream runs smoothly and without hiccups. Today we have many tools that help you manage your revenue cycle and increase your profits. Read on to discover the most important features any revenue cycle software should have, and learn about...

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How Can Technology Be Used to Engage Patients?

How Can Technology Be Used to Engage Patients?

How Can Technology Be Used to Engage Patients? People today rely heavily on technology for communication and access to information. Healthcare practitioners should take advantage of that and use technology to improve their patient engagement.  Improving patient interest and active participation in their treatment is a guaranteed way to better...

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What is CMS in Healthcare?

What is CMS in Healthcare?

What is CMS (Centers for Medicare & Medicaid Services) in Healthcare?The Centers for Medicare and Medicaid Services (CMS) is an integral part of the US Department of Health and Human Services. The CMS runs Medicare, Medicaid, Children’s Health Insurance Programs (CHIP), and state and federal insurance marketplaces.  This federal agency provides...

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Office Closure: Labor Day

Office closure

Office closure OFFICE CLOSURE As a reminder, Peregrine Healthcare's offices will be closed onFriday, April 15, 2022in observance of Good Friday. Offices will resume normal hours onMonday, April 18th and all calls will be returned. Thank you! Let’s Connect Please complete the information below to receive a complimentary practice analysis or more...

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Are Your Medical Billing Practices Healthy?

Are Your Medical Billing Practices Healthy?

Are Your Medical Billing Practices Healthy? (Quick Checklist)Each healthcare center relies on medical billing practices to keep a steady income flow. Setting up a good billing system can significantly improve the financial aspect of your medical practice and give you the freedom to commit to your patients entirely. Here, we present you with a few...

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Patient Safety Procedures for Office-Based Surgeries

Patient Safety Procedures for Office-Based Surgeries

Patient Safety Procedures for Office-Based Surgeries We have seen an increase in procedures performed in physician offices in recent years, including office-based surgeries. The problem was that many states didn’t have strict guidelines for these types of operations, in contrast to surgeries performed in hospitals that had strict protocols and...

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What Is Healthcare Management?

What Is Healthcare Management?

What Is Healthcare Management? The medical industry consists of more than physicians and nurses. There is personnel outside the operating room that does a vital job of managing a healthcare practice. Good healthcare management makes a medical facility more effective, profitable, and comfortable for patients and staff. So, what is healthcare...

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The 5 Steps of Successful Revenue Cycle Management

The 5 Steps of Successful Revenue Cycle Management

The 5 Steps of Successful Revenue Cycle Management Revenue cycle management is a vital part of any successful healthcare practice. It is a unique system that allows healthcare businesses to streamline their revenue, from the initial contact with the patient to final payments. Revenue cycle management requires billing software, and healthcare...

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What Are the Different Medical Practice Types?

What Are the Different Medical Practice Types?

What Are the Different Medical Practice Types? If you are a medical professional finishing education, specialization, or a training program and are looking to join or start a medical practice, there are several different options. You should get acquainted with each one to decide what’s the best course to reach your career goals. Here are the main...

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What is Healthcare Revenue Cycle Management

What is Healthcare Revenue Cycle Management

What is Healthcare Revenue Cycle Management Healthcare is a relatively complex industry that uses several systems to make operations smoother. One of those systems is the revenue cycle, and it covers everything from the registration of a patient to their final payments. Revenue cycle management uses medical billing software, and it is the bridge...

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How to Improve Patient Engagement in Healthcare?

How to Improve Patient Engagement in Healthcare?

How to Improve Patient Engagement in Healthcare? Many healthcare practices struggle to engage their customers and convince them to participate in their care plans. It doesn’t matter how good your expertise, experience, and medical procedures are if your patients struggle to understand them and fail to follow a treatment plan. That’s why many...

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What Is Healthcare Consulting?

What Is Healthcare Consulting?

What Is Healthcare Consulting? Healthcare consulting helps various healthcare institutions navigate their business. The medical industry is fast-paced and evolving, and you need to ensure you are meeting all standards and requirements. For many healthcare providers, it is challenging to balance their patient care work with other business aspects....

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What You Need to Know About Transitional Care from Hospital to Your Home

What You Need to Know About Transitional Care from Hospital to Your Home

What You Need to Know About Transitional Care from Hospital to Your Home Hospitals have transitional care practices to make it easier for patients to switch from the hospital environment to their homes. The goal of transitional care is to ensure the safety of patients during home-based treatment, reduce readmission rates, and prevent any negative...

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