How to reduce claim denials in your medical practice
Most denials come from a short list of repeatable causes: eligibility errors, missing authorizations, coding mistakes and late filing. That is good news, because repeatable errors can be prevented.
Read articleProvider credentialing: a step-by-step guide
Credentialing can take two to four months, and claims may go unpaid until it is complete. Start early, and keep documents ready: licenses, NPI, DEA, malpractice insurance, board certifications and work history.
Read articleWhat is revenue cycle management?
Revenue cycle management follows a patient account from scheduling to the final payment. Its stages include registration, eligibility, coding, claim submission, payment posting, denial management and patient collections.
Read articleIn-house vs outsourced medical billing
An in-house biller means salary, benefits, software and training, and one sick day can stop your cash flow. Outsourcing replaces that fixed cost with a team and a fee tied to what you collect.
Read articleNew practice billing checklist
Before seeing your first patient, obtain your NPI and tax ID, complete payer enrollment, choose your EHR and billing workflow, set your fee schedule and confirm your clearinghouse connection.
Read articleTelehealth billing basics
Telehealth claims depend on the right place-of-service code, modifiers and payer-specific policies, which can change often.
Read articleHow much do medical billing services cost?
Most medical billing companies charge a percentage of monthly collections, commonly in the low single digits, while others charge per claim or a flat monthly fee. The right model depends on your specialty, claim volume and the services included.
Read articleRejected vs denied claims: what is the difference?
A rejected claim fails basic format or data checks and never enters the payer system. It can usually be corrected and resubmitted right away. A denied claim was processed but refused payment, so it needs investigation and often an appeal.
Read articleICD-10, CPT and HCPCS codes explained
ICD-10-CM codes describe the diagnosis, CPT codes describe the procedure or service performed, and HCPCS Level II codes cover supplies, equipment and some drugs. Modifiers add detail that changes how a service is paid.
Read articleHow to reduce days in accounts receivable
Days in A/R measures how long it takes to collect payment after a service. A high number signals slow submission, denials or weak follow-up.
Read articleHIPAA compliance in medical billing
Billing involves protected health information, so every vendor must follow HIPAA privacy and security rules. That includes encrypted transmission, role-based access, staff training and a signed business associate agreement.
Read articleMedical billing for small practices
Small practices feel every denied claim. One biller on leave or one missed deadline can disrupt cash flow.
Read articleFind out what your practice is leaving on the table
Request a free practice audit. No obligation, no long-term contract.
Get my free audit