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Concept
Provider Enrollment
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Summary
Provider Enrollment
is the process by which
Healthcare Providers
become authorized to bill and receive payment from
Insurance companies
and
Government Healthcare Programs
. It involves credentialing, which verifies qualifications and compliance with
Regulatory Standards
, ensuring providers can deliver and be reimbursed for
Healthcare Services
.
Concepts
Credentialing
Reimbursement
Healthcare Compliance
Insurance Billing
Provider Networks
Regulatory Standards
Healthcare Administration
Medical Licensing
Provider Credentialing Verification
Medicare Administrative Contractor (MAC)
Relevant Degrees
Public and Professional Organization of Health 63%
Human Relations in the Enterprise 38%
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