Resources
Medical billing resources & guides
Practical guides on medical billing, denials, AR, coding, credentialing and specialty billing, for practice owners and billing teams.
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Out-of-Network Billing for Therapists
Private-pay and out-of-network therapists have four main billing options. Here is how each works, what to verify first and where the paperwork goes wrong.
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Medical Billing Setup for a New Practice
A step-by-step setup plan for a new practice's billing: identifiers, payer enrollment, systems, fee schedule, front-desk workflow and the checks that catch problems in the first months.
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KX Modifier and the Therapy Threshold
When Medicare outpatient therapy spending passes the annual threshold, the KX modifier tells CMS the care is still medically necessary. Here is how it works.
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IOP & PHP Billing Codes for Behavioral Health
The per diem, revenue and HCPCS codes used for intensive outpatient and partial hospitalization programs, how Medicare IOP works, and what Part 2 means for SUD claims.
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In-House vs Outsourced Medical Billing
A balanced comparison of running billing in-house or outsourcing it: how to compare true costs, the real advantages and drawbacks, HIPAA duties and how to make the switch safely.
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How to Switch Medical Billing Companies Without Losing Revenue
A practical transition plan for changing billing vendors: what to check in your current contract, how to secure your data, who works legacy AR and how to avoid a gap in collections.
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How to Reduce Days in A/R
Days in A/R measures how long money sits unpaid. Here is how to calculate it, where the days come from and the specific fixes that shorten each stage.
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How to Bill Secondary Insurance
When a patient has two plans, the order of billing and the primary payer's adjudication detail decide whether the secondary claim pays. Here is the process.
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How to Appeal a Denied Insurance Claim
A practical guide for billers and managers: when to appeal, Medicare's five appeal levels, commercial payer basics and a structured appeal letter outline you can reuse.
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How Much Does Credentialing Cost?
Credentialing costs come from a few fees, a lot of staff time and the revenue you lose while waiting. Here is how to add it up and compare in-house work with an outside service.
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