Best Medical Billing

Medical billing articles

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

151 articles · page 6 of 8

  • Holding Claims, Incident To, and Locum Tenens: Managing the Pre-Credentialing Gap

    When a new physician starts seeing patients before payer enrollment finishes, practices face a major revenue gap. We break down strict "incident-to" rules, locum tenens limitations, and the safest ways to hold claims to avoid compliance nightmares.

    September 9, 20269 min read

  • The Reality of Retroactive Billing After Credentialing in 2026

    New providers shouldn't sit idle while payers drag their feet on enrollment. Here is exactly how to hold claims, track effective dates, and bill retroactively once the approval finally lands.

    September 8, 20268 min read

  • The True Cost of Lapsed Provider Enrollment: Expired Credentials Consequences

    A lapsed state medical license or missed Medicare revalidation doesn't just pause your claims—it triggers out-of-network penalties, halts cash flow, and forces your billing team into an appeals nightmare. Here is exactly what it costs to drop the ball on credentialing.

    September 8, 20269 min read

  • Mastering BCBS Prior Authorization in 2026

    Blue Cross Blue Shield isn't one payer; it's 33 independent companies. Managing prior auths means tracking local rules, BlueCard routing, and 2026 Availity updates. Here is exactly how to get your BCBS claims paid without chasing your tail.

    September 7, 20268 min read

  • PR-27 Denial Code: Resolving Terminated Coverage Claims

    When a claim comes back PR-27, the payer is telling you the patient's policy was dead on the date of service. Here is how to track down replacement coverage, manage the COBRA waiting game, and legally shift the balance to the patient.

    September 7, 202610 min read

  • Empire BCBS (Anthem NY) 2026 Billing Guide & Timely Filing Limits

    New York billers know that managing Anthem NY—still widely known as Empire BCBS—requires strict adherence to tight deadlines. Missing the 120-day commercial filing window guarantees a denial. Here is exactly how to credential, bill, and appeal claims for this major NY payer in 2026.

    September 7, 20268 min read

  • The Provider Credentialing Process: 2026 Timelines, Traps, and Tactics

    A new physician starts on Monday, but if you didn't begin credentialing three months ago, they are working for free. Learn the exact 2026 timelines, documentation rules, and payer-specific hurdles to get your providers enrolled and billing.

    September 6, 20268 min read

  • OA-109 Denial Code: Wrong Payer or Contractor Billed

    An OA-109 denial means you billed the wrong insurance company or contractor. Learn why payers reject these claims, how to track down carved-out benefits like behavioral health, and the exact steps to reroute your claim to the right payer before timely filing deadlines expire.

    September 6, 20269 min read

  • How Long Does Credentialing Take in 2026? A Payer-by-Payer Timeline

    A new physician joining your practice means lost revenue every day they aren't fully credentialed. We break down exactly how long Medicare, Medicaid, and commercial payers are taking to process applications in 2026, and how to stop application delays before they start.

    September 6, 202610 min read

  • The Silent Revenue Leak: A Blueprint for Fixing Payer Underpayments

    A closed claim doesn't mean a correctly paid claim. If your auto-posting rules write off contract variances without flagging them, payers are quietly keeping your revenue. Here is how to catch the leaks and force compliance.

    September 6, 20269 min read

  • Benchmarking Your Appeal Overturn Rate in 2026

    Denials are climbing, but are your appeals actually working? If you don't know your overturn rate, you're flying blind. We break down what a healthy recovery benchmark looks like in 2026 and how to restructure your revenue cycle to win more payer disputes without burning staff hours.

    September 5, 202610 min read

  • Claim Rejection vs Denial: Stop Mixing Up Your A/R Workflows

    A rejection happens before adjudication because of bad data, stopping at the clearinghouse. A denial happens after processing, requiring a formal appeal. Treating a rejected claim like a denied claim wastes time, uses the wrong EDI codes, and stalls your cash flow.

    September 5, 20269 min read

  • State-by-State Guide to Prior Authorization Gold Carding (2026)

    If your physicians approve 90% of their prior authorizations, you shouldn't be filing them at all. Several states now legally require payers to grant "gold card" exemptions to high-performing providers. Here is how billing teams can track approval rates, claim exemptions, and bypass PAs.

    September 5, 20268 min read

  • The Ultimate 2026 Guide to Telehealth Billing and Coding

    Navigating telehealth claims in 2026 means mastering place of service codes, specific modifiers, and fragmented payer policies. Here is exactly how to get your virtual visits paid without facing audits or sudden clawbacks.

    September 5, 202615 min read

  • Decoding the 835: A Biller’s Guide to Reading Remittance Advice

    Stop guessing at adjustment codes. Master the anatomy of standard paper remits and electronic 835s to capture lost revenue, overturn denials, and balance your daily deposits.

    September 4, 20269 min read

  • Outsourced Eligibility Verification Services | Best Medical Billing

    Front desk staff rarely have the time to sit on hold with payers. We verify active coverage, exact deductibles, copays, and benefit limits before the patient walks through the door—killing CO-27 denials at the source and securing your cash flow.

    September 4, 202610 min read

  • The Reality of Medical Credentialing in 2026: Timelines & Traps

    Learn the exact steps, PECOS workflows, and CAQH requirements to get providers credentialed and billing in 2026 without suffering a 120-day cash flow gap.

    September 4, 20269 min read

  • How to Submit a Prior Authorization Request Under 2026 Guidelines

    Submitting prior authorizations has changed drastically in 2026. With CMS mandating faster turnaround times and shifting toward API integration, billers must adapt workflows. Here is exactly what you need to know to get approvals faster and reduce peer-to-peer friction.

    September 4, 20268 min read

  • CO-29 Denial Code: Fixing Timely Filing Expirations

    CO-29 is the universal denial for missing a timely filing deadline. It puts the financial hit squarely on the practice. To overturn it, you need airtight EDI clearinghouse reports or proof of retroactive eligibility. Here is how to fight timely filing expirations.

    September 3, 202610 min read

  • Stop Chasing Claims: Master the Root Cause Analysis of Denials

    Stop appealing the same codes over and over. Learn exactly how to dig past the CARC to find the origin of a denial, fix front-end processes, and protect your 2026 revenue.

    September 3, 202610 min read