Resources · blog archive
Medical billing blog archive page 5 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 5
- Payers and deadlinesProof of timely filing: what counts, where to find it and how to present itWhat counts as proof of timely filing, where billers find it (acknowledgements, R&S pages, delay reason codes) and how to present the appeal.Updated Read
- Practice operationsTen questions to ask a medical billing company, and the answers you want to hearTen questions to ask a medical billing company: data ownership, dedicated billers, denials, reporting, the BAA and the exit, with the answers you want.Updated Read
- Coding and documentationModifier 25 vs modifier 59: when each applies, and what NCCI expects you to proveModifier 25 vs modifier 59: one defends a separate visit on the day of a procedure, the other a distinct second procedure. How NCCI edits decide.Updated Read
- Credentialing and enrollmentMedicare revalidation: finding your due date and what deactivation costsMedicare posts revalidation due dates seven months ahead and sends notices three to four months before. How to find yours, and what a missed date costs.Updated Read
- Home care and home healthReview Choice Demonstration: how pre-claim review changes home health billing in six statesSix states' home health agencies bill under the Review Choice Demonstration, extended five years from June 2024. How pre-claim review reorders billing.Updated Read
- Payers and deadlinesUnitedHealthcare's prior authorization reductions: the dates, who they cover and what to check on the claimUnitedHealthcare lists prior authorization reductions from November 1 and December 1, 2026 and Part B step therapy from January 1, 2027. What to verify.Updated Read
- Credentialing and enrollmentRe-credentialing with a new NEMT broker: driver files, vehicle records and the clockWhen a state picks a new NEMT broker, providers re-credential: Medicaid enrollment, driver files, vehicle records, insurance. The packet and the timeline.Updated Read
- Payers and deadlinesWISeR: prior authorization comes to traditional Medicare in six statesThe WISeR model runs January 1, 2026 to 2031 in six states, adding prior authorization or pre-payment review to skin substitutes and two more services.Updated Read
- Coding and documentationWhen a payer downcodes your E/M level: Cigna's R49 and how to respondCigna's policy R49 reviews 99204-99205, 99214-99215 and 99244-99245 and can pay one level lower. What the policy says, and how to document and dispute.Read
- Denials and appealsWhat a 277CA rejection means, and why it never shows up on the ERAA 277CA tells you whether the payer's front end accepted your 837 or rejected it. Rejected claims never reach the 835, and the filing clock keeps running.Read
- Home care and home healthEVV aggregator changes in 2026: what Illinois's move to the HHAeXchange portal teaches every agencyIllinois moved in-home providers to the HHAeXchange EVV portal on March 2, 2026, enrollment due January 19. A checklist for any state's aggregator change.Read
- NEMT billingAmbulatory, wheelchair or stretcher: billing the right NEMT level of serviceBilling a wheelchair trip for a rider who walked is the upcoding the CMS NEMT booklet warns about. How level of service is set, documented and coded.Read
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