Still thinking about your denied claim? Look at the denial code to discover the reason. Each code highlights different issues in your claims, from coverage limitations to incorrect or missing payer information. By understanding the most recurring reasons, you can avoid the patterns or mistakes in your billing process that result in claim rejections. So, […]
CO 226 Denial Code Description, Reasons and Resolution Guide Read More »
You don’t take a one-size-fits-all approach with your patients, so why do the same with your revenue cycle? Every medical practice faces unique challenges that affect its cash flow. Pain management facilities are the same. With over 955 active physician groups and countless individual clinics across the USA, pain management is a growing specialty. Unfortunately,
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Are you ready to file your claim? Or have you forgotten an important modifier? Choosing the correct modifier can make all the difference, especially if you have performed several procedures on the same patient and within the same visit. Modifiers offer additional information to payers about a service or procedure. The best part is that
Modifier 51 vs 59 – What is the Difference? Read More »
Struggling to apply the correct CCM CPT codes for initial and extended care? Let us break down the differences so you can choose the right code for every situation. Chronic Care Management (CCM) services are a significant part of primary care. But did you know they are equally beneficial for both practices and patients? While
Chronic Care Management (CCM) CPT Codes 2024 Read More »
2024 has brought many interesting changes, especially in the code set for speech therapy. From eliminating CPT code 92506 and replacing it with four new specific evaluation codes to allowing speech therapists to bill for caregiver training in the absence of patients, the AMA offers a more direct approach toward reimbursements. However, there is one
Speech Therapy CPT Codes for Evaluation and Treatment 2024 Read More »
Just as authors use various circumstances and experiences to provide context in their books, modifiers do the same in medical billing. They provide additional information about procedures or services performed by healthcare providers. Modifiers are concise, two-digit codes that billing specialists pair with HCPCS or CPT codes. They can be alphabetic, numeric, or a combination
What is Modifier 58 in Medical Billing? Read More »
Are you tired of searching for easier and quicker ways to get credentialed with insurance companies? If you are like most doctors, becoming an in-network provider can feel frustrating due to endless paperwork, countless verifications, and tight deadlines. The biggest challenge? Figuring out what the insurance companies actually want. You can find information from various
How To Get Credentialed with Insurance Companies? Read More »
Don’t limit your potential by ignoring claim denials. Did you know that over 86% of denials are easily avoidable? Each denied claim represents a missed opportunity. While this may seem like a minor setback at first, it can quickly lead to significant losses. Unresolved claims can cost healthcare practices up to 5% of their net
Best Denial Management Companies in 2025 Read More »
According to the U.S. Centers for Medicare & Medicaid Services, private and government health insurance payers process over 5 billion medical claims annually. A complaint submitted to the U.S. Department of Justice stated that nearly 95% of these medical claims are transferred electronically via EDI clearinghouses. Since the rise of electronic medical claim filing, clearinghouses
Common Clearinghouse Rejection Codes During Claim Submission Read More »
Coding and its technologies have significantly evolved with time. While these continuous advancements improve the healthcare system in several ways, they also create problems for coders, especially those just starting their careers. As a result, many new coders face productivity issues. This is a major concern because coding productivity is directly linked with billing efficiency.
Tips for Maintaining Productivity of New Medical Coders Read More »
