Medical credentialing is the process of verifying the qualifications and credentials of healthcare providers to ensure that they meet certain standards and criteria before they can be eligible to participate in insurance programs and provide medical services to patients.
Medical credentialing is a crucial aspect of the healthcare system as it helps ensure that patients receive care from providers who have the necessary qualifications and expertise, and equally as important, to help ensure those providers are reimbursed for their services. The process is often time-consuming and complex. First Accurate provides credentialing along with medical coding and billing as a complete package, or as a standalone service.
Medical coding is the process of transforming descriptions of medical diagnoses and procedures into standardized numerical codes.
These codes are used for reimbursement purposes, for collecting
statistical data, and for the analysis of healthcare information. Medical
coders use coding systems, such as the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT), to assign
codes to medical records and claims. The accuracy of medical coding is important for both financial and clinical reasons.
Medical billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a healthcare provider. It involves using codes to represent different medical procedures and services, and requires a good understanding of insurance policies, government regulations, and payment laws. The goal of medical billing is to ensure that healthcare providers receive accurate and timely payment for their services and to minimize the financial burden on patients.