WCH BLOG

The Professional Provider Credentialing Process: A Step-by-Step GuideIn the healthcare industry, ensuring that medical professionals are qualified, experienced, and licensed to provide care is a critical responsibility. This process, known as provider credentialing, helps safeguard patients and main...

Running a medical practice is a balancing act that requires not only excellent clinical skills but also effective staff management. Physicians often face the challenge of improving productivity, ensuring patient satisfaction, mitigating legal and financial risks, and maintaining a high quality of ca...

Integration of artificial intelligence (AI) and automation into revenue cycle management (RCM) is not just a trend—it's a revolution. The transformation driven by these technologies promises to streamline processes, enhance efficiency, and significantly reduce errors, making it a topic of imme...

Medical billing is essential for healthcare providers to ensure smooth financial operations and maximize revenue. Healthcare providers send claims to insurance companies to receive payment for treating patients. Accuracy, efficiency, and compliance with regulatory requirements are paramount in this ...

As we approach the conclusion of 2023, it's an opportune moment to set our sights on the year ahead and craft resolutions that will shape the future of your practice. Whether you're contemplating a relocation, considering closing or opening a location, or exploring the addition of providers, now is ...

A significant change is on the horizon. As of December 1, there will be a mandatory shift from paper-based to electronic submissions for medical pre-service appeals concerning commercial, UnitedHealthcare® Medicare Advantage, and Dual Special Needs Plan (D-SNP) plans. Providers will now be requ...

As of January 1, 2024, eviCore Healthcare (“eviCore”) will discontinue providing health plan-sponsored services through the Palladian/eviCore PNP Agreement for the Emblem program. The termination of this program is set to take effect on December 31, 2023. This signif...

As of February 2, 2024, UnitedHealthcare is implementing a significant update for healthcare professionals and facilities associated with UnitedHealthcare Community Plans (Medicaid) in New Jersey. The change involves the discontinuation of mailed claim letters for most medical network healthcare pro...

The rise of telemedicine has been nothing short of transformative. With the advent of technology, healthcare providers have expanded their reach, offering medical services to patients far and wide. However, as convenient and promising as this shift may be, it comes with a unique set of challenges an...

It's a common misconception to believe that being a part of an insurance company's network automatically includes all the plans that the company offers. Let's delve into this misunderstanding by taking the example of Anthem Blue Cross Blue Shield and National Health Plan. We'll explore why participa...

Pain Points  A homecare agency faced a common challenge in the healthcare industry: reimbursement rates. Seeking clarity and improved revenue, they approached WCH for a second opinion on their billing processes. Their primary objectives were to understand their current ...

Facing an insurance audit can be a nerve-wracking experience for healthcare providers. However, it's crucial to remember that audits are part of the industry's checks and balances, ensuring compliance and accuracy. In this article, we provide essential insights on how to respond effe...

Every decision holds weight, none more so than the choice to switch billing companies. As you contemplate making this significant shift, considerations arise about contracts, terminations, and finding a billing partner that aligns with your practice's vision. Let's delve into the ess...

Running a successful medical practice involves a delicate balance of patient care, administrative efficiency, and effective management. While the healthcare industry is evolving rapidly, there are timeless strategies that can help ensure the long-term success of your medical practice...

All medical practices are constantly seeking ways to optimize their services and generate additional revenue streams. One such opportunity lies in the often overlooked realm of immigration physicals. We will show how medical practice can successfully implement immigration physicals, ...