Blog topic
Medical billing
How a visit becomes a payment in a US practice: the CMS-1500 and UB-04 claim forms, place-of-service codes, charge entry, the EOB and the ERA, allowed amounts, what billing companies charge, and what revenue cycle management covers from the visit to the deposit. Each guide explains the term, shows where it turns up in your own billing, and what to check when something doesn’t add up.
Medical billing
How Much Do Medical Billing Companies Charge?
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.
Medical billing
2027 Medicare Fee Schedule: What Changes for Practices
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
What Is the HCFA Form? A CMS-1500 Guide for Practices
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
UB-04 Form (CMS-1450) in Medical Billing: A Complete Guide
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 in Medical Billing: Definition and Billing Rules
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.
Medical billing
What Is Revenue Cycle Management? A Guide for US Practices
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.
Medical billing
Outsourced Medical Billing Services: When They Pay Off
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.
Medical billing
What Is Medical Billing? A Step-by-Step Guide for Practices
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 billing
What Is an EOB in Medical Billing? How to Read One
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
What Is the Allowed Amount in 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
What Is Charge Entry in 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
What Is ERA in Medical Billing? The 835 Remittance Explained
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.
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