Understanding Medicare Jurisdiction L (JL): Key Updates for Providers
Medicare providers in Pennsylvania and Maryland fall under Medicare Jurisdiction L (JL), administered by Novitas Solutions. Staying updated on JL-specific policies, enrollment changes, and billing requirements is crucial for seamless reimbursement and compliance. In this article, we’ll break down the latest updates from Novitas Solutions, key credentialing steps, and how providers can avoid common pitfalls in Medicare JL. What […]
How to Credential with Aetna [2025]
If you’re a healthcare provider aiming to work with Aetna, one of the largest health insurance companies in the U.S., credentialing is your critical first step. Without it, you simply can’t bill Aetna or see its insured patients. But don’t stress — this guide will walk you through everything from document prep to final contract […]
Mastering UnitedHealthcare Credentialing [2025]
Credentialing with UnitedHealthcare (UHC) is a pivotal step for healthcare providers aiming to serve a broader patient base and ensure timely reimbursements. This guide delves into the intricacies of the UHC credentialing process, offering insights, resources, and best practices to navigate it efficiently. Understanding UnitedHealthcare Credentialing Credentialing is the process by which UHC verifies a […]
Medicare Credentialing – All You Need to Know
If you’re a healthcare provider hoping to serve Medicare patients, credentialing isn’t just an annoying formality—it’s your golden ticket to legally bill Medicare and get reimbursed. Whether you’re a physician opening your own clinic, a nurse practitioner joining a group practice, or an administrator running a large hospital, understanding Medicare credentialing is non-negotiable. Let’s break […]
Starting Your Telemental Health Practice in New York: A Step-by-Step Guide
Step 1: Obtain Your New York State License Understanding Licensure Requirements To legally practice telemental health in New York, obtaining a state license is paramount. The New York State Education Department (NYSED) oversees the licensure of mental health professionals. Depending on your specialization—be it as a Licensed Mental Health Counselor (LMHC), Licensed Clinical Social […]
Beneficial Ownership Filing: How to Stay Compliant with the CTA?
Introduction Beneficial Ownership Filing has become a cornerstone of business compliance in an era where corporate transparency is key to fostering trust and accountability. The Corporate Transparency Act (CTA), enforced by the Financial Crimes Enforcement Network (FinCEN), mandates this filing to curb financial crimes like money laundering and tax evasion. For U.S. businesses, understanding and […]
Strategies to Reduce OB/GYN claim denials
Medical billing for OB/GYN practices isn’t just a back-office function—it’s the financial backbone of the business. Yet, many OB/GYN providers face costly pitfalls: coding errors, claim denials, compliance risks, and revenue leaks. As healthcare regulations tighten and coding complexities grow, mastering OB/GYN medical billing is no longer optional—it’s essential. If you’re a provider, practice manager, […]
ENT Medical Billing Services: Boost Your Practice’s Efficiency and Revenue
Understanding the Complexity of ENT Medical Billing Managing medical billing for ENT (Ear, Nose, and Throat) practices is intricate and constantly changing. With frequent updates to government regulations, handling billing internally can become overwhelming. This complexity raises an important question: Should your practice continue managing billing in-house, or is it time to outsource to […]
Understanding the 7th Character “S” of Sequela in Medical Coding
In the realm of medical coding, understanding the nuances of coding systems is vital for healthcare providers, coders, and billing specialists. One critical aspect of this is the 7th character “S,” which signifies sequela, or the after-effects of a previous injury or condition. Knowing how to accurately apply this character can have significant financial implications for medical practices. […]
Difference between refund and recoupment in medical billing
Introduction Significance of Refund and Recoupment in Medical Billing In the realm of medical billing, understanding the significance of refund and recoupment is crucial for maintaining financial health. While both involve the return of funds, they operate in distinct contexts, necessitating a clear understanding to navigate the intricate landscape of healthcare revenue management effectively. The […]
