Medicare credentialing  All the providers must be credentialed with Medicare before start billing for their services. Group practices and the providers within the group must be separately credentialed and linked…

Provider credentialing Physician credentialing is the process by which insurance networks, healthcare organizations, and hospitals obtain and evaluate documentation regarding a medical provider's education, training, work history, licensure, regulatory compliance…

EOB (Explanation Of Benefits) After a claim processes in medical billing, payment follows. Each payment is accompanied by an explanation of benefits, or EOB. The EOB is sent to the…

Superbill A superbill is an itemized form, used by healthcare providers in the United States, which details the services provided to a patient. It is the main data source for…

Diagnosis Diagnosis describe any diseases, illnesses or injuries a patient may have. It can be represented in a claim as ICD 10  code. ICD-10 codes are alphanumeric codes used by…

Procedure code Procedure code denotes CPT (Current Procedural Terminology) which is a set of medical codes used by physicians, healthcare professionals, nonphysician practitioners, hospitals, outpatient facilities, and laboratories to describe…