Credentialing happens before a provider is considered eligible to participate in an insurance network. Recredentialing is done every 1-3 years after the original effective date of the provider to make sure that all of the information listed with the insurance panel are up to date and accurate.

 An EMR (electronic medical record) is a digital version of a chart with patient information stored in a computer and an EHR (electronic health record) is a digital record of health information.

 Meaningful Use is defined as the use of certified electronic health record or EHR software in practices, hospitals, clinics, and by other medical service providers to improve efficiency, safety, and overall quality of care.

MACRA combines parts of the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VBM), and the Medicare Electronic Health Record (EHR) incentive program into one single program called the Merit-based Incentive Payment System, or “MIPS”.

 HMO stands for Health Maintenance Organization, and the coverage restricts patients to a particular group of physicians called a network.1 PPO is short for Preferred Provider Organization and allows patients to choose any physician they wish, either inside or outside of their network.2 HMOs and PPOs are both types of managed care, which is a way for insurers to help control costs.

 Value-based programs reward health care providers with incentive payments for the quality of care they give to people with Medicare.

A modifier is a code that provides the means by which the reporting physician can indicate that a service or procedure that has been performed has been altered by some specific circumstance but has not changed in its definition or code. In simple words, they are used to give a concise view of the medical billing demonstrating the type of services and procedures provided by the physician or healthcare organization. 

 In medical billing, RVU refers to Relative Value Units – a set of standard values assigned by Medicare to determine the cost of services.

One Stop and its team of medical billing and credentialing specialists understand the time and effort it takes to run an efficient medical office. That is why every office receives specialized attention and a tailored plan to help your practice succeed. Every contract is priced according to the needs of your practice and is always based upon volume.

Yes, we provide billing and credentialing to laboratories of all types. 

Once you have signed on as a client, your practice will be given a dedicated account executive. This person is your primary contact should any questions or concerns arise. You can relax knowing that we have taken on the burden of the medical services process so you can focus on your patient care. 

Since our fee structure is based on a percentage model, we only make money when you do. Our innovative tools partnered with our expertise in medical billing mean that we are capable of increasing the dollar amounts of your claims while decreasing their turnaround time. Don’t think of our medical billing as an expense, think of it as an investment that will increase in your profits.

All providers have different challenges and goals, so it is important for One Stop to be flexible in the services we provide. Our first priority is to offer services that promote the best interest of your practice for the long term.