Billing & Coding Guides

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

Did you know that many healthcare practitioners get confused when it comes to the timely filing limit and appeal filing limit? As if medical billing were not intricate enough on its own, the terminology mix-up further complicates things.  The reason is simple. Timing is not just a metric. It is the difference between revenue and

Perhaps, among their non-clinical duties, the most taxing task for healthcare providers is claim submissions. Why? Because they have to be careful about small billing details, otherwise they face reimbursement denials.  In 2025’s Experian Research, over 40% of providers said that at least 10% of claims are denied. This is a worrisome statistic for medical

Did you know that with proper verification of benefits (VOB), you can reduce denials related to eligibility and prior authorization? Moreover, you get clarity into the patient’s financial responsibility.  Wondering how? Because VOB in medical billing is an integral step that allows you to confirm a patient’s active insurance, specific coverage for services, and financial

Did you know that there are nearly 47,225 cardiologists in the U.S.? These include 9,594 interventional, 4,328 electrophysiology, and 973 heart failure (HF) physicians.  Undoubtedly, cardiology is a highly complex specialty, and management of its revenue cycle matches its reputation. Thus, we decided to dedicate this guide to discussing cardiology revenue cycle management (RCM) guidelines.