Contract Management: Managing agreements between providers and payers
Posted: Wed May 21, 2025 4:21 am
A generic service or type of company specializing in "Physician Data Management": This is a broader category of services and software that helps healthcare organizations, payers, and even individual physician practices manage the vast amount of data related to healthcare providers. These services often include:
This software helps track, centralize, and manage all information about healthcare providers. This includes:
Credentialing and Privileging: Verifying a physician's qualifications, licenses, certifications, and granting them permission to practice in a specific facility.
Payer Enrollment: Enrolling physicians with lbank database commercial and government insurance payers so they can be reimbursed for services.
Directory Management: Ensuring physician directories (online and print) are accurate and up-to-date for patients and other providers. This is crucial for compliance with regulations like the federal Consolidated Appropriations Act (CAA) of 2021, which requires regular verification of directory information.
Performance and Quality Reporting: Tracking a physician's performance against quality metrics.
Compliance: Helping organizations meet regulatory requirements related to provider data.
Revenue Cycle Management (RCM): Services that help healthcare providers manage their financial processes, from patient registration and appointment scheduling to billing, claims submission, and payment collection. This often involves significant data management.
This software helps track, centralize, and manage all information about healthcare providers. This includes:
Credentialing and Privileging: Verifying a physician's qualifications, licenses, certifications, and granting them permission to practice in a specific facility.
Payer Enrollment: Enrolling physicians with lbank database commercial and government insurance payers so they can be reimbursed for services.
Directory Management: Ensuring physician directories (online and print) are accurate and up-to-date for patients and other providers. This is crucial for compliance with regulations like the federal Consolidated Appropriations Act (CAA) of 2021, which requires regular verification of directory information.
Performance and Quality Reporting: Tracking a physician's performance against quality metrics.
Compliance: Helping organizations meet regulatory requirements related to provider data.
Revenue Cycle Management (RCM): Services that help healthcare providers manage their financial processes, from patient registration and appointment scheduling to billing, claims submission, and payment collection. This often involves significant data management.