The revenue cycle
Alongside every stage
Not sure where revenue is slipping?
Start with a free consultation. No patient information, no commitment.
Resources
Guides to medical billing, coding, credentialing and the revenue cycle, written for US practices.
32 guides
Newest · Specialty billing
CPT 90834 is 38 to 52 minutes of psychotherapy; 90837 is 53 minutes or more. The minutes documented in the note decide the code, not the length of the appointment slot. Here are the time bands, worked session examples, the add-on codes, and the documentation that holds up in a review.
Medical billing
Medical billing companies charge in one of three ways: a percentage of what they collect, a fee per claim, or a flat monthly fee. Here is what each model rewards, what the fee usually leaves out, how to compare quotes on one basis, and the contract terms to read before you sign.
Compliance
Since January 1, 2026, Medicare Advantage, Medicaid and CHIP plans must decide prior authorization requests within 72 hours (urgent) or 7 calendar days (standard) and give a specific reason for every denial. Here is who the rule covers, what comes in 2027, and the WISeR model.
Medical billing
The 2027 Medicare physician fee schedule is still a proposal. As written, the conversion factor most practices are paid under falls 1.68%, to $32.84, on January 1, 2027. Here is what else changes, what it means in dollars, and what to do before January.
Medical billing
The HCFA form is the old name for the CMS-1500, the claim form physicians and other practitioners use to bill insurers for professional services. Here is what each key box means, how it relates to the electronic 837P, and the errors that get claims rejected or denied.
Medical billing
The UB-04 (CMS-1450) is the claim form hospitals, skilled nursing facilities, hospices, home health agencies and other facilities use to bill for institutional services. Which providers use it, the form locators that matter most, the errors that hold claims up, and how it differs from the CMS-1500.
Medical billing
POS 11 is the place of service code for care given in a physician's office. It tells the payer to pay the non-facility rate, so using it where it doesn't belong, or missing it where it does, changes what you are paid. When to use it, the common mistakes, and the codes to use instead.
Specialty billing
CPT 90791 is a psychiatric diagnostic evaluation without medical services; 90792 is the same evaluation with medical services. Which one you bill depends on what the note shows was done. Here is how to choose, what Medicare won't let you bill with them, and the mistakes that cause denials.
Medical billing
Revenue cycle management (RCM) is everything a practice does to get paid for a visit, from checking insurance before the patient arrives to collecting the last dollar of the balance. Here are its eight steps, where money slips at each, the numbers to watch, and how to decide what to keep in-house.
Specialty billing
Seven billing and coding mistakes that cost physical therapy practices money: unit counting under the 8-minute rule, the GP and KX modifiers, code pairs that need 59 or an X modifier, untimed codes, plans of care, progress reports and 97014. How to spot each in your own claims, and how to fix it.
Denials & A/R
Medical claims get denied for a short list of reasons: coverage or patient details, missing information, duplicates, late filing, codes that don't fit together, bundling, medical necessity and missing authorization. Here is the code each one carries on your remittance and the fix at the source.
Compliance
A medical billing compliance checklist for a US practice: ten areas, each with the specific checks to run, from loading the new code sets and testing E/M documentation to HIPAA risk analysis, NCCI edits, overpayments and staff training, plus when in the year to run each one.
Credentialing
A credentialing delay costs every insured visit a new provider can't bill in network, while you pay their salary. Here is a worked example of that cost, why enrollment stalls, a step-by-step plan for enrolling a provider, and the dates that keep them enrolled.
Medical coding
Medical coding turns a visit into codes; medical billing turns those codes into a claim and follows it until it's paid. How the two differ, how each one fails, and how to tell whether a denial is a coding problem or a billing problem.
Denials & A/R
Days in A/R is your total accounts receivable divided by your average daily charges. Here is how to calculate it with a worked example, what pushes it up, and a week-by-week plan to reduce AR days: faster claims, cleaner claims, and every unpaid claim worked by age before its deadline.
Specialty billing
Many DME claims stall on the paperwork, not the payer: an incomplete order, missing proof of delivery, a face-to-face visit or prior authorization Medicare needed before delivery, or the wrong rental modifier. What Medicare requires for each, and what a supplier can check before billing.
Medical billing
Outsourcing your billing adds revenue only when it fixes something that is costing you money now: claims that wait, denials nobody works, A/R nobody chases, or a team that costs more than a billing company would. Here is how to tell, what to ask a vendor, and what changes in the first months.
Specialty billing
Most behavioral health denials come from a few causes: a time code the note doesn't support, an add-on billed without its E/M visit, a claim sent to the wrong company, telehealth details and thin notes. Here is each one, the reason code it comes back with, and what to change.
Medical billing
Medical billing is how a practice turns a patient visit into payment: it bills the visit to the patient's insurance as a claim, follows the claim until it is paid, and bills the patient for their share. Here is each step in plain English, with one visit followed from check-in to final payment.
Medical coding
Medical coding turns what a provider documented into the codes a payer reads: ICD-10-CM for why the patient was seen, CPT and HCPCS for what was done. How it works, the three code sets, the mistakes that cause denials and what to check in your own practice.
Specialty billing
Internal medicine billing turns an internist's visits into coded claims and follows them until they're paid. It is harder than most because one visit often covers several chronic conditions, a preventive service and a Medicare patient. Here is how it works, where it goes wrong and what to check.
Specialty billing
Under the Medicare 8-minute rule, you add up all the timed therapy minutes in a day and bill one 15-minute unit for every 15 minutes, with 8 or more minutes left over counting as one more unit. Here is the unit chart, CMS's own worked examples and the mistakes that get therapy claims cut.
Medical coding
Skin tags are coded L91.8 wherever they are on the body, inflamed or not; anal tags are K64.4. The billable codes, the codes that are misused or not billable, the CPT codes for removal, and what a payer needs to see before it pays for a removal.
Medical coding
There is no single ICD-10 code for anemia: anemia codes run from D50 to D64, and the right one depends on the type and cause the provider documents. The common codes, how to sequence anemia in kidney disease and cancer, and the coding mistakes that get claims denied.
Medical coding
R42 is the ICD-10-CM code for dizziness and giddiness. Use it when dizziness is the reason for the visit and no cause has been confirmed, and replace it once the provider documents a diagnosis. Here is what it covers, what it excludes and the mistakes that get it denied.
Medical coding
A CPT code is the five-character code, published by the AMA, that tells a payer what service a provider performed. What CPT stands for, the three categories, how a code sits on a claim line, and the CPT mistakes that get claims denied.
Denials & A/R
Denial management works as a weekly routine, not a project: log every denial by its reason code, work the nearest deadlines and largest amounts first, appeal with evidence, and fix the step that caused each repeat. Here is how to set it up, with a first-week checklist.
Credentialing
Credentialing is an insurance company checking that a provider is qualified before adding them to its network. Until it's done and the provider is enrolled, that payer won't pay their claims in network. Here is how it works, what slows it down and what to have ready.
Medical billing
An EOB, or explanation of benefits, is a payer's statement of how it processed a claim: what was billed, what the plan allows, what it paid and what the patient owes. Here is how to read one, what to check before you post it, and what to tell a patient who calls about theirs.
Medical billing
The allowed amount is the most a health plan will pay for a covered service: the insurer's share plus the patient's. It comes from your contract or the payer's fee schedule, not from your charge. How it is split, a worked example, and how to check that payers paid what they allowed.
Medical billing
Charge entry is recording each visit's services, codes and charges in your billing system so a claim can be built from them. It sits between coding and claim submission, and a charge that is missed or entered wrong is never billed or comes back denied. The steps, what goes wrong, how to check it.
Medical billing
An ERA, or electronic remittance advice, is the payer's electronic explanation of a payment: which claims it paid, how much, and why each amount differs from what you billed. Here is what an ERA contains, how it is posted, and what to set up so your payments and deposits match.
Unsure how much revenue you are missing? Start with a complimentary billing audit.
Free consultation