Best Medical Billing

Medical billing articles

Denial resolution, payer policy, coding references and revenue cycle operations.

31 articles · page 1 of 2

  • Comprehensive RCM Company Services for Medical Practices

    Stop losing revenue to payer delays and automated denials. Our comprehensive RCM services cover the entire billing lifecycle, from charge capture and coding to aggressive denial appeals and patient collections, ensuring you get paid for every service you provide.

    September 3, 202611 min read

  • Anthem Prior Authorization Requirements & Billing Guidelines 2026

    Stop losing revenue to CO-197 denials. Learn the exact 2026 Availity workflows, Carelon guidelines, and EDI requirements needed to get Anthem prior authorizations approved and paid.

    September 3, 20268 min read

  • Medical Billing by Payer: The Definitive 2026 Strategy Guide

    Every payer has its own rulebook. This definitive 2026 guide breaks down the massive differences between Medicare, Medicaid, Commercial, and specialized payers so your practice can stop leaking revenue and start getting paid on time.

    September 2, 202612 min read

  • Empire BCBS Prior Authorization Requirements (2026 Guide)

    Submitting auths to Empire BCBS requires mastering the Availity portal's Interactive Care Reviewer. Missing a clinical cut-off or submitting an auth post-service guarantees a denial. Here is exactly how to manage New York's biggest Blues plan this year.

    September 1, 20268 min read

  • Small Practice Medical Billing Services | Best Medical Billing

    Running a small medical practice leaves zero room for unworked denials or slow cash flow. Best Medical Billing provides end-to-end revenue cycle management, acting as your dedicated back office so you can focus on patient care instead of chasing down UnitedHealthcare or Medicare for payment.

    September 1, 202610 min read

  • Stop Letting Payers Waste Your Time: The 2026 Guide to Gold Carding

    Gold carding exempts high-performing providers from prior auths, but it completely changes your front-end claim edits and denial management workflows. Here is how to keep your exemptions active and stop erroneous CO-197 denials.

    September 1, 20269 min read

  • CO-50 Denial Code: Overturning Medical Necessity Rejections

    When a claim comes back with a CO-50 denial code, the payer is telling you the service was not medically necessary—and contractually, you must eat the cost. Here is how to audit diagnosis pointers, leverage 2026 LCDs, and build a clinical appeal that forces reimbursement.

    September 1, 202610 min read

  • Medical Billing Denial Management Services | Best Medical Billing

    Payers rely on automated algorithms to deny claims, hoping you lack the staff to fight back. Our denial management team aggressively works your zero-pay ERAs, clinical appeals, and older A/R to recover the revenue your practice already earned.

    August 31, 202612 min read

  • Centene Prior Authorization Requirements: 2026 Biller's Guide

    Managing prior authorizations for Centene subsidiaries like Ambetter and WellCare requires knowing exactly which state-level rules apply. Here is how medical billers can secure approvals, beat peer-to-peer deadlines, and avoid medical necessity denials under the new 2026 CMS mandates.

    August 31, 20269 min read

  • Independence Blue Cross Timely Filing Rules & Billing Guide

    Missing an Independence Blue Cross deadline costs your practice money. Here is the exact breakdown of the 180-day timely filing limit, how to navigate the PEAR portal in 2026, and strategies to overturn past-deadline denials in Pennsylvania's biggest market.

    August 31, 20267 min read

  • CMS Prior Authorization API Requirements: What Billers Must Do Before 2027

    The January 2027 CMS interoperability deadline is just months away. If you manage a medical billing team, these mandatory FHIR APIs will radically change how your practice handles coverage discovery, documentation rules, and payer turnaround times.

    August 30, 20269 min read

  • Fix the CO-97 Denial Code (Bundled Services)

    A CO-97 denial means the payer bundled your service into another procedure on the same claim. Here is exactly how to navigate NCCI edits, apply the correct modifiers, and overturn invalid bundling denials in 2026.

    August 30, 202610 min read

  • Comprehensive Revenue Cycle Management Services for Medical Practices

    Outpatient margins are thinner than ever in 2026. Our end-to-end revenue cycle management stops revenue leakage by attacking front-end errors, accelerating cash flow, and aggressively working complex payer denials before they write off.

    August 30, 202611 min read

  • CO-197 Denial Code: Resolving Missing Prior Authorizations

    A CO-197 denial means a claim lacked required prior authorization. Discover how to track down missing auth numbers, appeal mismatched CPT codes, and utilize 2026 retro-authorization rules to get these claims paid instead of written off.

    August 30, 20269 min read

  • Oscar Health Billing Guide: Timely Filing, Claims, and Appeals

    Oscar Health relies on tight networks and strict filing deadlines. Missing the 120-day cutoff means an automatic write-off. Here is exactly how to credential, bill, and appeal Oscar Health claims in 2026 without leaving money on the table.

    August 29, 20269 min read

  • Fixing the CO-31 Denial Code: Patient Cannot Be Identified as Our Insured

    When a payer kicks back a claim with CO-31, they are saying the patient doesn't exist in their system. This is almost always a demographic typo, a mismatched payer ID, or an eligibility issue that requires a quick verification and a corrected claim.

    August 28, 202610 min read

  • OA-23 Denial Code: How to Balance Secondary Claims and Prior Payer Adjustments

    Seeing an OA-23 adjustment means your secondary payer factored in what the primary already paid. It isn't always a hard denial, but when it leaves a zero balance, you need to know how to read the remittance advice and fix your Coordination of Benefits looping.

    August 28, 20269 min read

  • CO-16 Denial Code: Finding Missing Claim Information and Correcting Errors

    CARC 16 means your claim is missing information required for adjudication. Here is how to find the accompanying remark code, supply the missing data, and push the claim through payer systems.

    August 28, 202610 min read

  • Aetna Prior Authorization Requirements & Billing Guide

    Getting an Aetna auth doesn't have to ruin your Tuesday. We break down the 2026 Aetna prior authorization guidelines, from Availity Essentials workflow to surviving peer-to-peer appeals for high-dollar claims.

    August 28, 20267 min read

  • Kaiser Permanente Prior Authorization Requirements & Billing Guide (2026)

    Billing a closed-network HMO like Kaiser Permanente requires playing by strict rules. From navigating referral workflows to understanding the 2026 timelines for outside billing, here is what your practice needs to know to get paid when treating Kaiser members.

    August 28, 20269 min read