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…

Timely Filing Limit The time frame for a claim submitted to the insurance is referred as a timely filing limit. It is set by the insurance companies to submit the…