Insurance credentialing, often times referred to as provider enrollment, is the process of becoming affiliated with an insurance company as an in-network/participating provider. Accurate credentialing and enrollment is a critical part of starting and maintaining a medical practice to receive payment for services rendered. Mistakes and/or omissions will result in lost revenue, or at the very least, delayed reimbursement. It is important to understand the credentialing terminology commonly used.
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Published May 28, 2019