MIPS The Merit-based Incentive Payment System (MIPS) is one of the two payment tracks created under MACRA; the other is the Advanced Alternative Payment Model (AAPM) track. MIPS adjusts payment…

EDI Enrollments EDI is an abbreviation for Electronic Data Interchange, an innovative electronic communication technology. It is a structured way to transmit data between computer systems using established message formats…

Medicare credentialing  All the providers must be credentialed with Medicare before start billing for their services. Group practices and the providers within the group must be separately credentialed and linked…

Provider credentialing Physician credentialing is the process by which insurance networks, healthcare organizations, and hospitals obtain and evaluate documentation regarding a medical provider's education, training, work history, licensure, regulatory compliance…

EOB (Explanation Of Benefits) After a claim processes in medical billing, payment follows. Each payment is accompanied by an explanation of benefits, or EOB. The EOB is sent to the…

Superbill A superbill is an itemized form, used by healthcare providers in the United States, which details the services provided to a patient. It is the main data source for…