Billing & Coding Guides

Did you know that on average, 41% of healthcare providers face claim denial rates of at least 10%?  Even though you can resolve most denials by submitting a reworked claim or an appeal letter, things are not as simple as they seem. The reason? It costs you, on average, $25 per claim for practices and […]

Medicare G-codes sound a little too complex, don’t they? But they are a necessary part of Medicare medical billing. When it comes to billing payers for the services physicians, medical facilities, or other healthcare providers render, these G-codes are used for accuracy and standardized reporting.  Healthcare professionals often encounter payment delays and denials due to

Do you know that an orthopedic surgeon may receive, on average, $1,542.32 as an individual payment for their services? While this may seem a lot for a single surgical procedure, immense effort and paperwork are required for the orthopedic surgeon to claim it. One such hurdle that the specialists must hop over on their path

Most insurance carriers require a W-9 form from both in- and out-of-network healthcare practitioners. But have you ever wondered why it is so integral, not only for reimbursement, but also for credentialing? A W-9 is a standardized legal document that payers use to collect your EIN or tax ID numbers. Now, here’s a fun fact:

Do you want to know what the relative value unit (RVU) is? It is a primary component of the resource-based relative value scale (RBRVS).  For context, the Centers for Medicare & Medicaid (CMS) and other commercial payers use it to determine payment against physician services. This guide will explore RVU in medical billing in detail,

Nursing homes are becoming more popular with the aging population. In 2020, the U.S. Centers for Disease Control and Prevention (CDC) reported that around 1.3 million people were enrolled in over 15,000 certified nursing homes. Now, there are over 25,000 nursing homes in the US. These centers provide skilled nursing, rehabilitation, and other services to

Struggling to apply the correct Chronic Care Management (CCM) CPT codes for initial and extended care? Let us break down the differences so you can choose the right code for every situation. CCM services are a significant part of primary care. But did you know they are equally beneficial for both practices and patients? While

“How confident are you about using the right Durable Medical Equipment (DME) codes? We all know that proper coding can save you from payment delays. But did you know that DME is usually covered by the Healthcare Common Procedure Coding System (HCPCS) instead of CPT codes? DMEs are primarily covered by HCPCS’ level II codes

Are you one of the thousands of home health agencies striving to get the claims approved? The delay and denials may be the result of coding errors that occurred while reporting CPT and HCPCS codes for home health services.  In this comprehensive blog, we will uncover the most frequently provided home health products and services

Imagine you performed a comprehensive treatment for a procedure, but after a few days, the insurance payer sends the reimbursement check directly to the patient. While rare, this can happen. The reason? Failure to get a signed assignment of benefits from the patient. In this guide, we have simplified what assignment of benefits in medical