Credentialing Archives - MedBillingTech

Oklahoma SoonerSelect Credentialing: The Transition Explained

Oklahoma moved most of its Medicaid population into managed care under SoonerSelect, and being a SoonerCare provider no longer means you can bill for most of your Medicaid patients. This guide explains how SoonerSelect works, the two-step enrollment it requires, and what trips providers up, especially behavioral health providers.

By Mark Wood October 5, 2026Credentialing4 Comments

Credentialing

Hospital Privileging vs Payer Credentialing: What’s the Difference?

Payer credentialing and hospital privileging get used interchangeably, but they answer completely different questions. One determines whether an insurer will pay you. The other determines whether a hospital will let you perform specific procedures on its premises. A provider can have one without the other, and confusing them creates costly gaps. Here's how they differ and why it matters.

By Mark Wood July 13, 2026Credentialing

Credentialing

Do You Need Credentialing Software or a Service?

The software-versus-service question really comes down to one thing: whether you have credentialing expertise in-house. Software is a tool that makes a knowledgeable person faster. A service is a team that supplies the knowledge and does the work. Buying the wrong one is how practices end up paying for a platform nobody has time to run. Here's how to tell which fits.

By Mark Wood July 9, 2026Credentialing

Credentialing

Behavioral Health Credentialing: Why It’s Different and What to Watch For

Behavioral health credentialing follows the same basic mechanics as any other credentialing, but a handful of differences make it harder, slower, and easier to get wrong: the carve-out structure most payers use, a thicket of license types that vary by state, supervision rules for associate-level clinicians, and separate substance use disorder requirements. Here's what makes it distinct and how a group should handle it.

By Mark Wood July 6, 2026Credentialing

Credentialing

Medicaid Provider Enrollment: A Practical Guide for 2026

Medicaid provider enrollment sounds like it should mirror Medicare, but it doesn't. Medicaid is not one program, it's 50-plus separate programs, one per state, each with its own portal, forms, timelines, and quirks. This guide explains how it actually works, the federal rules that apply everywhere, where states diverge, and the 2026 revalidation push every Medicaid provider needs to be ready for.

By Mark Wood July 2, 2026Credentialing

Credentialing

Closed Payer Panels: What to Do When a Panel Won’t Accept You

A provider finishes credentialing cleanly and gets rejected anyway, because the payer's panel is closed to new providers in their area. It has nothing to do with their qualifications. Here's why panels close, the real options for getting onto one, and how to keep seeing patients while you work on it.

By Mark Wood June 29, 2026Credentialing

Credentialing

Credentialing After Relocating Your Practice

A provider moves one state over, with the same insurers they've worked with for years, updates their address, and assumes billing continues. Two weeks later the claims start bouncing. Credentials don't automatically follow you when you relocate. Here's why, and how to move without creating a billing gap.

By Mark Wood June 25, 2026Credentialing

Credentialing

CAQH vs PECOS vs NPPES: What’s the Difference?

NPPES, CAQH, and PECOS sound interchangeable, they all hold provider data, and they all want the same information. But they're three separate systems with three distinct jobs, they don't sync automatically, and a mismatch between them causes denials. Here's what each does and how they interact.

By Mark Wood June 19, 2026Credentialing

Credentialing

Provider Credentialing: The Complete Guide

Provider credentialing is the gateway between hiring a clinician and that clinician generating revenue. It's also poorly understood and getting harder in 2026. This complete guide defines what credentialing actually is, walks through the full process, covers the systems involved, and links to detailed deep-dives on every subtopic.

By Mark Wood June 8, 2026Credentialing