Medical credentialing is a lengthy process with many formalities and workflows involved. The process involves a series of steps and might take anywhere between three and six months. It requires a thorough evaluation of the application sent by the provider, for which the provider would have to submit all the necessary documentation along with his or her credentials. This is followed by verification of the practice or facility of the provider.

Subsequently, the payer’s database would be…

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EDI (electronic data interchange) is a secure way for healthcare and associated organizations to exchange data securely. Not only is it convenient, but also ensures complete security and compliance with existing regulations. Before the implementation of a uniform EDI, healthcare providers across the country used various different information standards and data formats to exchange information. Needless to point out, this posed a highly fragmented workflow that was also prone to errors.…

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The larger a hospital gets, the more the number of services it is likely to offer. It invariably means more medical staff, more administrative staff, a greater volume of patients, more data, and more management burden. Hospital management that is at least moderately large is bound to have its testing and imaging facilities, the results of which need to be compiled appropriately.

In light of this, using a digital platform to manage day-to-day operations at a hospital becomes a…

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In healthcare, Electronic data interchange (EDI) in healthcare is a secure means of communicating information between hospitals, clinics, insurance payers, and patients using specific messaging standards and formats. Having an EDI streamlines day-to-day operations at hospitals as well as associated organizations like health insurance companies and clearinghouses.

But it was not always standardized. Different manufacturers developed their own data formats for transmitting medical data…

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Medical coding is an integral part of the operations of the healthcare industry in the United States of America. In simple words, medical coding is a process in which a professional translates healthcare diagnoses, tests, scans, treatments, and medical services into universal medical alphanumeric codes. The information that is coded is taken from the documentation of the medical records of a patient. The purpose of medical coding is to summarize patients’ medical reports into billable… Continue

In healthcare,Revenue cycle management (RCM) in healthcare is the process of tracking the revenues from patients from the appointment to the final payment of bills. Healthcare revenue cycles in the United States have a highly bureaucratic, meandering labyrinth of regulations and processes. A small misstep in any of them could delay or lose precious revenue for providers. That is why healthcare RCM services are extremely important for providers to maintain and improve their bottom… Continue

It is estimated that more than 40% of Americans suffer from at least one chronic disease. Many of them even suffer from more than one. Furthermore, experts estimate that the cost of chronic diseases, including the healthcare cost and the loss in economic productivity, to be approximately $3.7 trillion each year. Specialists in public health concur that this is a genuine healthcare crisis in the country.



Chronic diseases, unlike other types of diseases, require continued care and… Continue

Everybody is aware of the complexity of maintaining steady revenues in healthcare provider organizations. There is a highly elaborate, bureaucratic process that begins with medical documentation, followed by medical coding, filling out claims, and finally submitting them. But before all of this, the non-clinical staff verifies the insurance coverage of each patient before they’re examined by a doctor.



Mistakes in any of the steps, or errors in any information entered could cost the… Continue

Remote patient monitoring (RPM) is the use of digital and telecommunication technology for monitoring patients outside medical settings. In other words, providers monitor patient vitals when the patients are not in a clinic or a hospital. The idea might seem novel, but the concept has been around for well over a decade. But few in the medical and legal circles gave it serious consideration.



There were personal gadgets like smartwatches and Fitbits that allowed people to monitor their… Continue