Billing & Coding Guides

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.

Are you a healthcare facility wondering how to get paid for your ancillary services and patient stays? The UB-04 claim form is the key. It is a standardized form that payers accept for facility-related charges. However, understanding it requires attention to detail. Luckily, this guide covers everything you need to know about it, from its

Is sitting on the desk, looking at the claim form, making you nervous because there are so many fields, and especially when two types of provider entries are required, i.e., billing and rendering? We understand this feeling. Medical billing is complex and can confuse even the most seasoned professionals. But you don’t have to worry.

Claim forms, such as the CMS-1500, serve as the backbone of the revenue cycle management (RCM) for healthcare practices. It serves key functions that expand beyond requesting payment for the rendered care services. When you submit the claim form, you initiate the payment collection process. Besides, it acts as a legal document between the provider,

Medical billing is the backbone of any healthcare organization, regardless of its size, specialty, or type. But why is it so? If your medical billing operations are not seamless, you will have higher denials, unsteady cash flow, aging accounts receivable, and a strained revenue cycle. Ultimately, unnecessary write-offs will become inevitable, and eventually, it will

Healthcare is becoming more accessible with over 6,300 Medicare-certified ambulatory surgery centers (ASCs) around the USA. In 2023, the market size for US-based ASCs was valued at 36.51 billion, and it is projected to reach 57.32 billion by 2031.  With such tremendous growth on the horizon, it is imperative that you understand the implications of