Credentialing Hotline Blog
Stay ahead of payer requirements, regulatory changes, and best practices that keep your providers in-network.
Featured
“Apply for Commercial Insurance Contracts Without”
Fresh out of residency with zero claims history? Here is the direct path to getting your first commercial insurance contracts without getting stuck in credentialing limbo.
“Hospital Privileging by Proxy for Telehealth”
Privileging by proxy should be a shortcut, but for locum tenens telehealth providers, it's often a compliance trap. Here is how to handle 2025 CMS rules without losing your mind.
“Link Your NPI to a Group”
You just graduated and have an NPI, but you aren't getting paid yet. Here is how to actually link that NPI to your new group practice using PECOS without losing your mind.
“Direct Payer Enrollment vs Third-Party TPA”
New practices often choose between the slow burn of direct payer contracts and the quick 'wrapper' coverage of TPAs. Here is how that choice hits your bottom line.
“Mitigating OIG Exclusion Liability for 2025”
Writing off $200k because an MA didn't disclose a shoplifting charge? Here is how to handle OIG exclusion liability without losing your mind or your revenue.
“Florida House Bill 837 Medical Staff”
Florida's legal shifts mean your hospital bylaws aren't just HR documents anymore—they are your primary defense against litigation. Here is what's changing for 2025.
“Cost-Benefit Analysis”
Is your practice better off handling the CMS-855 flurry in-house or hiring pros? We break down the math and the headaches of PECOS management for 2025.
“Medicare Part B Opt-Out vs Private”
Ditching Medicare isn't as simple as just not billing them. If you want to see Medicare patients for cash, you need a bulletproof opt-out strategy for 2025.
“Stop Revenue Leakage During the 2025”
New NPs and PAs cost money every day they aren't billing. Here is how RCM leads can tighten the credentialing cycle and stop the bleeding.
“BCBS and Aetna Credentialing for Out-of-State”
Getting locums providers credentialed for out-of-state telehealth is a grind. We break down the 2025 requirements for BCBS and Aetna so you stop losing revenue to avoidable denials.
“Fixing Your Medicare Billing Hold from”
When Medicare freezes your payments because of a pending 855A, your RCM goes into cardiac arrest. Here is how to get the cash moving again in 2025.
“Stop These Common OIG Exclusion Screening”
One missed name variation on the LEIE can trigger a $10,000 fine per claim. Here is how to audit your screening process before the OIG audits you.
Updates on Medicare, commercial payers, CAQH, and hospital privileging.