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Healthcare News

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Changes in Pharmacy Enrollment: Medicaid Compliance and Medicare Approval

9/15/2023
Changes in pharmacy enrollment requirements have significant implications for providers, particularly in states like New York and potentially others. These changes necessitate a shift from simply managing a registered Medicaid pharmacy to meeting the requirements of fee-for-service p...
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Buying vs. Starting a Durable Medical Supply Company: A Strategic Perspective

9/8/2023
For business entrepreneurs venturing into the world of durable medical supplies, a common dilemma arises: Should you buy an existing DME (Durable Medical Equipment) company or start a brand-new one from scratch? The answer to this question is not one-size-fits-all and depends on vari...
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The Complexity of CCM and RPM Billing: Understanding Insurance Company Policies

9/8/2023
Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) services have become essential components of patient care and revenue generation. However, the path to reimbursement for these services is not always straightforward. Each insurance company has its unique set of requiremen...
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Demystifying Medicare Enrollment: What Providers Need to Know

9/1/2023
Medicare enrollment is a fundamental step for healthcare providers looking to serve the senior population effectively. However, the process can seem daunting, with numerous requirements and steps to follow. In this article, we break down the basic prerequisites for Medicare enrollmen...
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Navigating Billing and Credentialing: The Cornerstone of Healthcare Success

8/25/2023
For any medical practitioner seeking to enhance their practice and ensure seamless operations, mastering the realms of billing and credentialing is an absolute necessity. These two pillars form the foundation of a successful medical business, demanding a comprehensive understanding of...
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Medicare's Paper Claim Submission

8/18/2023
We need hardly say that the process of claim submission holds significant weight. Among the various methods of submitting claims, paper-based submissions continue to play a crucial role in facilitating efficient communication between healthcare providers and payers. However, to ensur...
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UnitedHealthcare and Oxford Plan Members

8/18/2023
Navigating patient coverage is a cornerstone of effective healthcare administration. You need to know that some Oxford plan members, patients who are members of UnitedHealthcare Choice Plus or UnitedHealthcare Core are in network with your practice. To ensure seamless care and effici...
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Navigating MetroPlus' Non-Renewals: WCH Consulting Offers Support

8/11/2023
Providers often find themselves grappling with policy changes and evolving regulations. The recent policy of non-renewals by MetroPlus has caused waves among New York providers, leaving them concerned about the future of their affiliations. Amid this uncertainty, WCH Consulting steps...
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Navigating the Challenges of Credentialing for Physical Therapists

8/11/2023
The challenges faced by physical therapists seeking a foothold in the insurance industry are becoming increasingly apparent. As new waves of graduated physical therapist students step into the arena, the influx of fresh talent is both promising and challenging, amplifying the competi...
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Navigating IPA Selection: Why WCH Credentialing is Your Second Opinion Solution

8/7/2023
In today's complex healthcare landscape, selecting the best Independent Practice Association (IPA) for your medical practice can be a daunting task. Understanding the intricacies of IPA rates and billing can often lead to uncertainties about the IPA's functions and potential future o...
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The Compact State Licensure: Unlocking New Opportunities

7/28/2023
In recent times, the buzz around compact state licensure has been growing louder within the community. If you are unfamiliar with this concept, it's time to understand what it entails and how it can be a game-changer in your career. Compact states are a group of states that have come...
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Unlocking New Opportunities: Navigating State-to-State Medical Practice

7/28/2023
In today's interconnected world, opportunities for doctors to practice in different states are more accessible than ever before. The prospect of reaching patients beyond state borders can be enticing, offering additional revenue streams and a chance to expand one's reach as a healthc...
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Navigating Business Transitions: Ensuring Fair Reimbursement in the Mental Health Industry

7/21/2023
As of March 1, 2023, Carelon has stepped into the spotlight as a new processing vendor for mental health, taking over from Beacon. With this transition, providers in the industry must exercise caution and vigilance in reviewing their reimbursement to ensure they are not being underpa...
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Maximizing Opportunities: The Synergy of Billing and Credentialing

7/14/2023
Billing and credentialing are two critical components that go hand in hand. Properly aligning these processes can lead to significant opportunities for healthcare providers. By partnering with a professional company that specializes in billing and credentialing, providers can unlock ...
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Navigating the Complex World of Regional Healthcare Contracts: Partnering with WCH for Credentialing Success

7/7/2023
Regional contracts play a pivotal role in shaping market dynamics. With major players such as Aetna, Cigna, Blue Cross, and United Healthcare dominating the industry, their presence is felt in every state across the nation. While they may appear in every state, it's important to note...
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WCH News

September 15, 2023
Charting Your Path to a Successful Medical Practice: Guidance from WCH
For medical providers venturing into the world of private practice, the journey begins with crucial decisions that set the course for their business. One of the most pivotal choices is det...
September 15, 2023
Insurance Company Letters: The Importance of Professional Consulting
Receiving a letter from an insurance company can often be a daunting experience for healthcare providers. These letters can encompass a wide range of topics, from audit requests to clarifi...
September 08, 2023
Finding the Right Billing Company: Key Steps for Practice Growth
For many healthcare practitioners, the quest to find the ideal billing company is a critical step in ensuring practice growth and financial success. Doctors often wonder how to identify th...
September 01, 2023
The Power of a Second Opinion in Medical Billing
In the world of healthcare, seeking a second opinion is a common practice when it comes to our physical well-being. We rely on professionals to provide us with accurate evaluations and tre...

Healthcare News

September 15, 2023
Changes in Pharmacy Enrollment: Medicaid Compliance and Medicare Approval
Changes in pharmacy enrollment requirements have significant implications for providers, particularly in states like New York and potentially others. These changes necessitate a shift from...
September 08, 2023
Buying vs. Starting a Durable Medical Supply Company: A Strategic Perspective
For business entrepreneurs venturing into the world of durable medical supplies, a common dilemma arises: Should you buy an existing DME (Durable Medical Equipment) company or start a bran...
September 08, 2023
The Complexity of CCM and RPM Billing: Understanding Insurance Company Policies
Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) services have become essential components of patient care and revenue generation. However, the path to reimbursement for these...
September 01, 2023
Demystifying Medicare Enrollment: What Providers Need to Know
Medicare enrollment is a fundamental step for healthcare providers looking to serve the senior population effectively. However, the process can seem daunting, with numerous requirements and st...

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WCH can help your practice in your credentialing needs! Using a credentialing specialist with the knowledge, expertise and connections that can help position your practice ahead of time. Let us help you today! During credentialing process WCH becomes your external credentialing department for all communications, submissions, follow up and any other questions that will come up during the process.

WCH Specializes in:

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Medical billing services offered by WCH Service Bureau go far beyond the usual understanding of billing.

 

What we offer is not just excellent professional billing and collection services. We also stand as guardians of your reimbursement and compliance with federal, state laws and regulations as well as private insurance policies and procedures.

 

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Periodic medical chart auditing is vital for any healthcare provider and medical practice. Let the professionals evaluate your coding, billing, and documentation practices! Our auditors are AAPC-qualified CPMAs (Certified Professional Auditors) and CPCs (Certified Professional Coders). We perform comprehensive Chart Auditing. We can do the following services for you:

  • Identify areas of risk leading to upcoding or downcoding and medical coding accuracy;
  • Ensure that coding practices are compliant with the regulations set forth by private and government payers;
  • Evaluate Incident to guidelines and services performed on collaborative premises;
  • Perform Analysis of Denials/Duplicate billing /Appeal process/Modifier usage;
  • Review Front Desk work including but not limited to: Eligibility verification/Benefit maximums verification/Excluded services verification/Authorization process/Patient responsibility (deductibles, copays, coinsurance)/Coordination of benefits;
  • Evaluate Insurance plans participation and consistency of contracted rates;

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