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Medical billing blog archive page 3 of 6
Earlier posts, newest first. Each one is written and reviewed by the billing team, works through a hypothetical example and lists the sources it rests on. The latest posts, the category list and the search box are on the first page of the medical billing blog.
Posts on page 3
- Coding and documentationThe 2026 efficiency adjustment: which codes took the 2.5% work RVU cut, and which did notThe 2026 Medicare efficiency adjustment cut work RVUs for most procedures but spared time-based codes like E/M and care management. Who gained, who lost.Updated Read
- Denials and appealsHow to appeal a Medicare Part B denial: the five levels and their deadlinesMedicare Part B appeal deadlines run from the remittance for a redetermination, then from each decision after it. The five appeal levels and what to send.Updated Read
- Home care and home healthMedicaid work requirements and six-month renewals: what home care agencies should do before January 2027By January 1, 2027 states must apply Medicaid work requirements and more frequent renewals. What it means for home care authorizations and EVV visits.Updated Read
- Payers and deadlinesMedicare Advantage denials: how often appeals win, and why so few are filedKFF found most appealed Medicare Advantage denials were overturned in 2024, yet few were appealed at all. What the appeal rate means for your queue.Updated Read
- Practice operationsCollecting patient balances after the 2026 deductible jumpHigher 2026 deductibles, Medicare Part B's included, put more of each bill on the patient. How to collect patient balances before and after the visit.Updated Read
- Coding and documentationNCCI edits changed on October 1, 2026: how to check your top code pairsNCCI PTP edits v323r0 and new MUE values took effect on October 1, 2026. How to run your busiest code pairs against the new files before denials arrive.Updated Read
- Denials and appealsThe denial reasons practices report most in 2026, and the front-end fix for eachDenials are the top revenue leak for nearly half of medical groups, MGMA found in January 2026. The reasons, the benchmark rate and a fix for each.Updated Read
- Payers and deadlinesWhat the 2026 IDR operations rule changes for out-of-network claimsThe 2026 No Surprises Act IDR operations rule caps batch size and will move open negotiation into the federal portal. What changes for OON billing.Updated Read
- Coding and documentationSkin substitute billing in 2026: one payment rate, incident-to rules and WISeR prior authorizationSkin substitute billing in 2026: Medicare pays them as incident-to supplies priced per square centimeter, and the WISeR states add prior authorization.Updated Read
- Denials and appealsTimely filing when the payer or broker changes mid-yearBrokers, MCOs and clearinghouses change; filing limits do not pause. How timely filing after a payer transition works for Medicare, Medicaid and brokers.Updated Read
- Payers and deadlinesPrior authorization decision deadlines in 2026: 72 hours, seven days and the reason a payer must now giveFrom January 1, 2026, Medicare Advantage, Medicaid and CHIP plans must meet federal prior authorization decision timeframes and give a specific reason.Updated Read
- Credentialing and enrollmentMedicaid managed care enrollment, plan by plan: why each MCO is its own applicationMedicaid managed care enrollment is one state enrollment plus a contract with each MCO: the order, how states hand off, and the portal trail to keep.Updated Read
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