Code-level analysis, payer policy translations, and practical billing guidance — written by the people who run accounts, not a content agency.
Medicaid credentialing is really two processes. First, the provider enrolls with the state Medicaid agency. Then the provider is credentialed separately with
Physician billing services are outside companies that handle some or all of a practice’s revenue cycle: charge entry, coding, claim submission, payment
DNFB stands for discharged not final billed. It’s the set of patient accounts where the patient has been discharged and care is
Revenue codes are four-digit codes reported on the UB-04 (CMS-1450) institutional claim that tell the payer which department or type of service
What is prior authorization? It is the process where a health plan has to approve a service, procedure, or drug before the
CPT 99213 is an office or outpatient visit for an established patient that requires low medical decision making (MDM), or at least
The No Surprises Act took effect on January 1, 2022, and it affects physician practices in two main ways. You have to
Pass-through billing happens when a physician practice bills for a diagnostic test or lab service performed by an outside supplier as though
Every electronic medical claim submitted in the United States runs through the same standardized format behind the scenes, whether the practice knows
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