Category
Category: Denials & AR
How to read claim denial codes, reduce denials, and manage AR aging and insurance follow-up in a medical practice.
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Upcoding in Medical Billing: What It Is and How Practices Stay Clear of It
Few terms make a practice owner uneasy like "upcoding." It shows up in compliance training, payer newsletters, and audit letters — usually with the…
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Medical Billing Write-Offs: When to Write Off a Claim and How to Reduce Them
Medical Billing Write-Offs: When to Write Off a Claim and How to Reduce Them Every practice writes off some revenue. The difference between a…
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Insurance Underpayment Recovery: How to Spot Payer Underpayments and Get Paid What Your Contract Says
Most practices notice a denied claim — it stops payment entirely and lands on a worklist. An underpaid claim is quiet by comparison: the…
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Claim Rejection vs Denial: What Each One Needs Next
A rejected claim never reached the payer; a denied claim was processed and refused. The fix, the route and the deadline differ, and mixing them up costs time.
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Timely Filing Limits by Insurance
A claim filed one day late can be lost for good. Here are published filing limits for major payers, how each deadline is counted and where to confirm it.
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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 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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Corrected Claim vs Appeal vs Reconsideration
Three ways to change a claim outcome, and they are not interchangeable. Learn which one fits each denial, how frequency codes 7 and 8 work, and what Medicare does differently.
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CO-97 Denial Code: Bundled Services and How to Respond
CO-97 means the payer bundled a service into another it already paid. Learn how NCCI edits drive it, which remark codes appear, and when a modifier or appeal is right.
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CO-4 Denial Code: Modifier Mismatches and How to Fix Them
CO-4 means the payer found the procedure code inconsistent with the modifier on the line. Learn what triggers it, which remark codes explain it and how to correct the claim.
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