Struggles, Solutions & Success – Our medical billing Blog

How to Select the Best Credentialing Company in 2026

The credentialing company you choose controls how fast your providers get approved, how clean your claims stay, and how predictable your revenue remains. Pick the wrong partner, an...

ABA Credentialing Services: The Complete 2026 Guide for Healthcare Providers

Your BCBA has been on payroll for three months. They still can't see in-network clients. Every week without credentialing approval is revenue your practice will never recover. ...

How to Follow Up on Unpaid Medical Claims in 2026: The Complete Provider Guide

Denial rates hit nearly 12% in 2024, according to HFMA and Kodiak Solutions data. That number alone should concern any practice manager reading this. But here's what makes...

Oregon Medicaid Provider Enrollment: The 2026 Guide That Keeps Your Revenue Protected

Medicaid oregon provider enrollment is one of those processes that sounds straightforward until you're three weeks in, waiting on a status update that never comes. Oregon...

Physician Credentialing Services: The Complete Guide to Getting Credentialed Fast, Affordably, and Without the Headaches [2026]

You've just brought a new physician on board. They're qualified, eager to see patients, and ready to generate revenue for your practice. But there's a problem. Without ...

CO-234 Denial Code Description: Causes, Resolution & Prevention Guide

The CO-234 denial code means a billed procedure or service isn't separately payable. Also known as CO 234 denial code, it indicates the payer considers the service bundled into...

Nurse Practitioner Credentialing: The Complete Guide for 2026

The average nurse practitioner credentialing process takes 90 to 120 days. Every month of delay can cost a practice $15,000 to $25,000 in lost revenue from unbillable ser...

CPT Code 97162: The Complete Billing, Modifiers & Reimbursement Guide for 2026

CPT code 97162 is the billing code used to report a moderate-complexity physical therapy evaluation, typically involving approximately 30 minutes of face-to-face patient contact, a...

ICD-10 Code for UTI: Complete N39.0 Coding & Billing Guide (2026 Updated)

Urinary tract infections account for over 8.1 million outpatient visits annually in the United States. That's a massive volume of claims. Yet UTI-related denials rema...

CO-50 Denial Code: Description, Causes, Solutions & Prevention Guide

The CO-50 denial code (CARC 50) means the services you billed aren't covered because the payer doesn't consider them medically necessary. Per the official ANSI X12 cod...

What Is a Credentialing Specialist? The Complete Guide for Healthcare Providers

If you've ever waited 90+ days to get enrolled with an insurance payer, you already understand the problem. Every day without credentialing approval is a day your practice can&...

CO-4 Denial Code: Description, Causes, and How to Resolve It [2026 Guide]

Few things frustrate a billing team more than seeing the CO-4 denial code pop up on a remittance advice. You know the claim was valid. You know the service was rendered. But there ...

Modifier 26 in Medical Billing: The Complete 2026 Guide to the Professional Component

Billing diagnostic services with the wrong modifier costs practices thousands every month. One missing modifier 26 here, one incorrect TC there, and suddenly you're dealing wit...

CO-197 Denial Code: The Complete Guide to Resolution, Prevention & 2026 Updates

What is CO-197 Denial Code? The CO-197 denial code means your claim was rejected because prior authorization wasn't obtained before the service was performed. The official d...

CO-45 Denial Code: The Complete 2026 Guide for Healthcare Providers

Introduction The CO-45 denial code is one of the most frequently encountered adjustments in medical billing, yet it's also one of the most misunderstood....

Why Smart Practices Outsource Provider Enrollment to Stop Revenue Leaks (2026 Data)

Every day a provider sits in "pending" status, your practice loses $2,500 to $4,000 in unbillable revenue. That's not an estimate pulled from thin air. It's the a...

Why You Need Medicaid Credentialing Experts to Stop Revenue Leaks (2026 Update)

Medicaid isn't one program. It's 50 different state bureaucracies with 50 different portals, forms, timelines, and MCO layers. One taxonomy mismatch. One outdated address. ...

Modifier 24: The Complete 2026 Guide for Healthcare Providers

Every year, practices leave thousands of dollars on the table because they miss legitimate Modifier 24 opportunities. Or worse, they use the 24 modifier incorrectly and trigger den...

CO-22 Denial Code: Complete Guide to Coordination of Benefits Denials

The CO-22 denial code means a payer rejected your claim because they believe another insurance should pay first under coordination of benefits rules. This Claim Adjustment Reason C...

Credentialing Solutions for Therapists: The Complete Guide [2026]

You finished your degree, passed your exams, and got licensed. All that work, and you're ready to help clients. But here's the catch: you can't bill insurance until you...

PR-27 Denial Code: The Complete 2026 Guide to Resolution, Prevention & Appeals

INTRODUCTION Few things frustrate a billing team more than preventable denials. The PR-27 denial code and CO-27 denial code rank among the most common reasons claims get kicked ...

CPT Code 99213: The Definitive 2026 Provider Guide [+Reimbursement Rates & Free Tools]

CPT Code 99213 is an Evaluation and Management (E/M) code for an established patient office or outpatient visit lasting 20-29 minutes or requiring low-level medical decision-making...

Dental Credentialing Services: The Complete 2026 Guide for Dental Practices

Get Credentialed with Any Dental Insurance for Just $99 Expert dental credentialing services backed by 10 years of RCM experience. We handle Delta Dental, Aetna, Cigna, MetLife,...

CO-97 Denial Code: What It Means, Why It Happens & How to Fix It

CO-97 denial code means the payer considers your service already included in the payment for another procedure. When this appears on your remittance advice, the claim has been deni...

BCBS TX Provider Enrollment: The Complete 2026 Guide to Getting Approved in 45-60 Days (Not 90+)

Waiting three months for BCBS TX provider enrollment while every Blue Cross patient gets billed out-of-network? That's revenue you're never getting back. If you've deal...

CO-16 Denial Code: Complete Guide to Description, Causes, Fixes & Prevention

The CO-16 denial code means your claim lacks information or contains billing errors that stop the payer from processing it. This denial appears constantly in medical billing, and e...

POS 11 in Medical Billing: Complete Guide for Healthcare Providers

POS 11 at a Glance Code: 11 Meaning: Office Setting: Physician’s private practice, group practice, or standalone clinic Type: Outpatient only. Never inpatient ...

8-Minute Rule in Therapy Billing: The Complete Guide for PT, OT & SLP 2026

QUICK ANSWER: What is the 8-Minute Rule? The 8-minute rule is a Medicare billing guideline. Therapists must provide at least 8 minutes of direct, one-on-one treatment to b...

90837 CPT Code: The Complete 2026 Guide to 60-Minute Psychotherapy Billing

Let’s be honest about the 90837 CPT code. It is the one billing code every mental health provider wants to use, but it is also the one that keeps practice owners up at n...

The Best Credentialing Services for Mental Health Providers : From Application to Reimbursement in 2026

In 2026, the best credentialing services for mental health providers integrate enrollment directly with Revenue Cycle Management (RCM). Credentialing is no longer a one-time admini...

96110 CPT Code Billing, Modifiers, and Reimbursement Guide for Developmental Screening and Testing in 2026

The 96110 CPT code refers to developmental screening and testing—a standardized assessment for milestones (motor, language, and social) commonly used in pediatrics for early ...

Abdominal Pain ICD-10 Codes: Complete Provider Guide to Clean Claims, Accurate Coding & Faster Reimbursement (FY 2026)

The ICD-10-CM code for unspecified abdominal pain is R10.9, classified under Chapter 18 (Symptoms, signs, and abnormal clinical and laboratory findings) within the R10 category for...

DRG Validation: The Complete 2025 Guide to Accurate Inpatient Coding and Payment

Here’s the truth: the accuracy of DRG validation determines far more than how a single claim gets paid—it influences the entire financial rhythm of inpatient care. The ...

Difference Between CPT and HCPCS Codes: The Complete 2025 Guide for U.S. Healthcare Providers

Accurately understanding the difference between CPT and HCPCS codes is one of the most profitable skills a healthcare provider can learn. In real-world billing, denials rarely happ...

Hypertriglyceridemia ICD 10 (E78.1): Complete 2025 Coding and Billing Guide

Mistakes in ICD-10 coding may look small, but their impact is massive. A single misclassification in the hypertriglyceridemia ICD 10 code can halt payments, trigger audits, or even...

Most Common Mistakes in CMS-1500 Form

Every biller in healthcare knows the frustration of claim rejections caused by small, avoidable errors. The most common mistakes in CMS 1500 Form may seem trivial, such as a missin...

Resubmission Code for Corrected Claim — Meaning, Examples, and Step-by-Step Form Placement

Fixing a denied claim and sending it in with confidence, only to have it denied again, is extremely discouraging. These claims that were turned down take up your time, energy, and ...

Vitamin D Deficiency, ICD-10 (2025): Code, Documentation, and Reimbursement Guide

Quick ICD & CPT Reference (2025): ICD-10 code for Vitamin D Deficiency — E55.9; Vitamin D Insufficiency — E55.8; Vitamin D 25-hydroxy test — CPT 82306; Venipu...

RPM Billing Codes & CPT Guidelines 2025: Updated Reimbursement Rules, CPT List & Compliance Insights

Providing proactive healthcare services beyond the clinic walls is now complemented with consistent reimbursements for Remote Patient Monitoring (RPM) services. Most providers view...

What is Gross Collection Rate (GCR) in Medical Billing? A Complete 2025 Guide for Healthcare Providers

In 2025, understanding the Gross Collection Rate (GCR) is crucial for every healthcare provider aiming to strengthen financial stability and revenue optimization. This complete gui...

CPT Code 99214 Guide 2025: The Provider Billing, Documentation, and Reimbursement Playbook

Understanding cpt code 99214 shouldn’t feel like a daily fight, yet most providers say it does. You manage complex patients, review labs, adjust meds, interpret out...

Understanding DME Medical Billing: The Key to Accurate Reimbursements

Healthcare industry depends on patient care and financial process accuracy. DME medical billing is a complex billing process which requires a thorough understanding of insurance ru...

Behavioral Health Billing: A Detailed Guide for Providers

Introduction In healthcare industry the behavioral health practices are expanding as awareness of mental health is growing day by day and managing the financial side of these se...

Understanding the 90832 CPT Code in Medical Billing

Introduction: Medical billing specially for mental health services need a lot of attention, especially when it comes to using the right psychotherapy CPT codes. Among thes...

Medical Coding Audit: The Most Comprehensive 2025 Guide to Accuracy, Compliance & Revenue Integrity

A medical coding audit isn’t just a compliance checkpoint anymore—it’s one of the most reliable ways for a healthcare organization to protect its revenu...

Clearinghouse in Medical Billing: 2025 Provider Guide to Faster Claims and Fewer Denials

Your revenue depends more on the clearinghouse in medical billing than most providers realize. It quietly handles the part of the claim you never see, yet it decides how fast you g...

What Is Superbill in Medical Billing? Complete 2025 Provider Guide

A superbill is the document that explains a visit to the payer in clear, structured detail, and understanding what is superbill in medical billing helps providers prevent delays th...

EHR vs EMR What Healthcare Providers Need to Know

Introduction: As we know that healthcare industry is growing, and technology is helping in recorded, stored, and managed patient information. Among the most common terms that h...

Medical Billing Automation: Transforming the Future of Healthcare Billing with MedSole RCM

Introduction In healthcare sector the medical billing is always been one of the most complex areas. Providers have to deal with patient care, compliance requirements, insurance ...

The Role of CAQH in Medical Billing and Credentialing

Introduction: In the world of medical billing, accuracy and compliance are essential for healthcare practices to maintain steady revenue. The most important tool is CAQH in med...

Insurance Verification vs Authorization in Healthcare – A Complete Guide

Introduction: Healthcare billing can be complex for both doctors and patients. The two most important steps for better reimbursement are insurance verification vs authorization ...

Understanding the Medical Billing Process with MedSole RCM

Introduction: Now a days in healthcare industry, the accurate medical billing is very important for practices financial health. Providers and clinics across the United States d...

What is CAQH in Medical Billing and Why Providers Need It?

Medical billing in the United States is a complex system that requires providers to maintain accurate, verified, and updated information across multiple payers. One of the most imp...

Medicare Billing - A Complete Guide for Healthcare Providers

Introduction: Handling Medicare billing is one of the most important tasks for healthcare practices in the United States. With strict CMS rules, changing reimbursement policies,...

What Arizona Medical Billing and RCM Solutions Mean for Healthcare Practices

Introduction Running a medical practice in Arizona comes with unique challenges. From navigating payer regulations to ensuring timely reimbursements, providers need a support sy...

Denial Management Solutions: Building Stronger Revenue Cycles in Healthcare

Introduction: In healthcare billing, denials are one of the biggest challenges for providers, clinics, and hospitals. Due to denied claims there is not only loss in revenue but ...

RPM vs In Person Follow ups Which is More Effective for Achieving Better Chronic Care Results

Introduction: Healthcare delivery is transforming rapidly. With the help of technology, the tracking of patient’s health has become easy, making remote patient monitoring...

Patient Demographics Entry : The First Step Toward Accurate Medical Billing

Introduction In the medical billing cycle, patient demographics entry is the foundation for accurate claim submission and timely reimbursements. It involves collecting and enter...

How MedSole RCM Improves Accuracy and Payment Speed with Eligibility Verification and Prior Authorization

In the medical billing industry, two processes are very important directly impacting the provider’s cash flow: eligibility verification and prior authorization. These steps, ...

AR Follow Up in Medical Billing: Your 2025 Guide to Getting Paid Faster With Zero Guesswork

When payments slow or claims sit untouched, the pressure on your practice grows immediately. Most of these issues originate from inconsistent AR follow up in medical billing, where...

Medicare Payments to Psychiatric Facilities Set to Increase by 2.5%

Introduction: Medicare payments for Inpatient Psychiatric Facilities (IPFs) are set to rise by approximately 2.5% in fiscal year 2026, driven by the latest CMS rule. This regula...

What Is Electronic Claim Submission in Medical Billing

The process of sending a healthcare provider's claims to an insurance company or government program by using digital methods instead of paper forms, to get reimbursement and re...

Tips to start Reliable Behavioral Health Practice in the USA

AS we all know that Mental health awareness is rising across the whole United States, and along with this, the demand for behavioral health services increases. In America, we have ...

Your Guide to Remote Patient Monitoring Billing

Attractive Growth of Medicare Remote Patient Monitoring in Healthcare In the era of evolving U.S. healthcare, remote patient monitoring Medicare services are transforming that h...

Outstanding Role of Eligibility Verification and Prior Authorization in 2025

Our team provides eligibility verification and prior authorization services with accuracy and consistency. We work directly with payers to confirm benefit details and initiate appr...

Why Rural Clinics in Arizona Are Outsourcing Their Medical Billing in 2025

Healthcare services are going through big changes, especially in the rural parts of Arizona. Clinics in these areas are having more paperwork, strict rules and regulations, and les...

Hospitals Gain Financially from Outsourced RCM Services

In today’s healthcare industry, almost every practice face challenges for growing especially hospitals, they have to focus on boosting revenue and manage administrative burde...

The Financial Benefits of Outsourcing RCM Solutions for Private Practices

Private medical practices face increasing financial pressure, from rising operational costs to shrinking reimbursement margins. Effective RCM Solutions (Revenue Cycle Management) p...

What Top Medical Billing Companies in the USA Do Differently

In today’s complex healthcare environment, practices face significant challenges in managing revenue cycle operations. That's where a top medical billing company like Med...

Top 20 reasons claims are denied and how denial management fix them

Claim denials are one of the most regular challenges in medical billing. Whether it's a missing modifier, incorrect code, or expired insurance, every denial delay revenue and c...

Measuring and Addressing Physician Burnout in Healthcare

In recent years we have noticed that physician burnout is like one of the biggest threats for healthcare stability, its alarming also. They have to do long hours of working, manage...

How MAC Affects Your Claim Approvals and Reimbursements

Managing and handling Medicare billing is a challenge that is not only about correct coding and timely submissions. The important part of this process are Medicare Administrative C...

Medicare Guidelines for Remote Patient Monitoring (RPM): What it covers & what’s not

Now a days in healthcare industry Remote Patient Monitoring (RPM) has become an important component, helping providers to give services other than clinic as well. Especially for pa...

Eligibility Verification and Prior Authorization: What’s the Difference?

In Medical billing there is a lot of things to be handle, even for experienced doctors and practice managers. With insurance rules constantly changing, new online portals for every...

The Role of RCM Reporting in Improving Collections and Cash Flow

You know what’s the common challenge for medical practice now a days? Its managing collections and maintaining cash flow. From delayed reimbursements to denial rates, practic...

Why Are Eligibility Verification and Prior Authorization So Important in Preventing Claim Denials?

In today’s healthcare environment, accurate billing starts before a claim is submitted. Eligibility verification and prior authorization play an important role in minimizing ...

What is MAC (Medical Administrative Contractor) and How Does it Work in Medical Billing?

Medical Administrative Contractors (MACs) play a critical role in healthcare reimbursement specially in Medicare system. Understanding of MAC is very important for all healthcare p...

Why RCM Reporting Is the Key to Better Financial Decisions in Healthcare?

Revenue Cycle Management (RCM) is the financial backbone of every healthcare organization. From patient registration to final payment, every step in the billing cycle impacts cash ...

Medical RCM Solutions: Resolving Revenue Leakage for Healthcare Providers

The financial health of a healthcare organization depends heavily on its ability to manage revenue efficiently. From patient registration to final payment, every step in the revenu...

Our Latest Blog

How to Select the Best Credentialing Company in 2026

ABA Credentialing Services: The Complete 2026 Guide for Healthcare Providers

How to Follow Up on Unpaid Medical Claims in 2026: The Complete Provider Guide

Oregon Medicaid Provider Enrollment: The 2026 Guide That Keeps Your Revenue Protected

Physician Credentialing Services: The Complete Guide to Getting Credentialed Fast, Affordably, and Without the Headaches [2026]

CO-234 Denial Code Description: Causes, Resolution & Prevention Guide

Nurse Practitioner Credentialing: The Complete Guide for 2026

CPT Code 97162: The Complete Billing, Modifiers & Reimbursement Guide for 2026

ICD-10 Code for UTI: Complete N39.0 Coding & Billing Guide (2026 Updated)

CO-50 Denial Code: Description, Causes, Solutions & Prevention Guide

What Is a Credentialing Specialist? The Complete Guide for Healthcare Providers

CO-4 Denial Code: Description, Causes, and How to Resolve It [2026 Guide]

Modifier 26 in Medical Billing: The Complete 2026 Guide to the Professional Component

CO-197 Denial Code: The Complete Guide to Resolution, Prevention & 2026 Updates

CO-45 Denial Code: The Complete 2026 Guide for Healthcare Providers

Why Smart Practices Outsource Provider Enrollment to Stop Revenue Leaks (2026 Data)

Why You Need Medicaid Credentialing Experts to Stop Revenue Leaks (2026 Update)

Modifier 24: The Complete 2026 Guide for Healthcare Providers

CO-22 Denial Code: Complete Guide to Coordination of Benefits Denials

Credentialing Solutions for Therapists: The Complete Guide [2026]

PR-27 Denial Code: The Complete 2026 Guide to Resolution, Prevention & Appeals

CPT Code 99213: The Definitive 2026 Provider Guide [+Reimbursement Rates & Free Tools]

Dental Credentialing Services: The Complete 2026 Guide for Dental Practices

CO-97 Denial Code: What It Means, Why It Happens & How to Fix It

BCBS TX Provider Enrollment: The Complete 2026 Guide to Getting Approved in 45-60 Days (Not 90+)

CO-16 Denial Code: Complete Guide to Description, Causes, Fixes & Prevention

POS 11 in Medical Billing: Complete Guide for Healthcare Providers

8-Minute Rule in Therapy Billing: The Complete Guide for PT, OT & SLP 2026

90837 CPT Code: The Complete 2026 Guide to 60-Minute Psychotherapy Billing

The Best Credentialing Services for Mental Health Providers : From Application to Reimbursement in 2026

96110 CPT Code Billing, Modifiers, and Reimbursement Guide for Developmental Screening and Testing in 2026

Abdominal Pain ICD-10 Codes: Complete Provider Guide to Clean Claims, Accurate Coding & Faster Reimbursement (FY 2026)

DRG Validation: The Complete 2025 Guide to Accurate Inpatient Coding and Payment

Difference Between CPT and HCPCS Codes: The Complete 2025 Guide for U.S. Healthcare Providers

Hypertriglyceridemia ICD 10 (E78.1): Complete 2025 Coding and Billing Guide

Most Common Mistakes in CMS-1500 Form

Resubmission Code for Corrected Claim — Meaning, Examples, and Step-by-Step Form Placement

Vitamin D Deficiency, ICD-10 (2025): Code, Documentation, and Reimbursement Guide

RPM Billing Codes & CPT Guidelines 2025: Updated Reimbursement Rules, CPT List & Compliance Insights

What is Gross Collection Rate (GCR) in Medical Billing? A Complete 2025 Guide for Healthcare Providers

CPT Code 99214 Guide 2025: The Provider Billing, Documentation, and Reimbursement Playbook

Understanding DME Medical Billing: The Key to Accurate Reimbursements

Behavioral Health Billing: A Detailed Guide for Providers

Understanding the 90832 CPT Code in Medical Billing

Medical Coding Audit: The Most Comprehensive 2025 Guide to Accuracy, Compliance & Revenue Integrity

Clearinghouse in Medical Billing: 2025 Provider Guide to Faster Claims and Fewer Denials

What Is Superbill in Medical Billing? Complete 2025 Provider Guide

EHR vs EMR What Healthcare Providers Need to Know

Medical Billing Automation: Transforming the Future of Healthcare Billing with MedSole RCM

The Role of CAQH in Medical Billing and Credentialing

Insurance Verification vs Authorization in Healthcare – A Complete Guide

Understanding the Medical Billing Process with MedSole RCM

What is CAQH in Medical Billing and Why Providers Need It?

Medicare Billing - A Complete Guide for Healthcare Providers

What Arizona Medical Billing and RCM Solutions Mean for Healthcare Practices

Denial Management Solutions: Building Stronger Revenue Cycles in Healthcare

RPM vs In Person Follow ups Which is More Effective for Achieving Better Chronic Care Results

Patient Demographics Entry : The First Step Toward Accurate Medical Billing

How MedSole RCM Improves Accuracy and Payment Speed with Eligibility Verification and Prior Authorization

AR Follow Up in Medical Billing: Your 2025 Guide to Getting Paid Faster With Zero Guesswork

Medicare Payments to Psychiatric Facilities Set to Increase by 2.5%

What Is Electronic Claim Submission in Medical Billing

Tips to start Reliable Behavioral Health Practice in the USA

Your Guide to Remote Patient Monitoring Billing

Outstanding Role of Eligibility Verification and Prior Authorization in 2025

Why Rural Clinics in Arizona Are Outsourcing Their Medical Billing in 2025

Hospitals Gain Financially from Outsourced RCM Services

The Financial Benefits of Outsourcing RCM Solutions for Private Practices

What Top Medical Billing Companies in the USA Do Differently

Top 20 reasons claims are denied and how denial management fix them

Measuring and Addressing Physician Burnout in Healthcare

How MAC Affects Your Claim Approvals and Reimbursements

Medicare Guidelines for Remote Patient Monitoring (RPM): What it covers & what’s not

Eligibility Verification and Prior Authorization: What’s the Difference?

The Role of RCM Reporting in Improving Collections and Cash Flow

Why Are Eligibility Verification and Prior Authorization So Important in Preventing Claim Denials?

What is MAC (Medical Administrative Contractor) and How Does it Work in Medical Billing?

Why RCM Reporting Is the Key to Better Financial Decisions in Healthcare?

Medical RCM Solutions: Resolving Revenue Leakage for Healthcare Providers