A family doctor bills Medicare. Every patient visit gets coded as level 4 or level 5. These are the highest codes. They pay the most
A cardiology practice bills Medicare for three years without problems. Claims get paid. Revenue flows. Everything seems fine. Then a letter arrives from a Medicare
A multi-specialty practice signs with a medical billing company advertising a 5% collection rate. The sales representative emphasizes how affordable and comprehensive their services are.
Applied Behavior Analysis therapy helps people with many different challenges learn new skills and improve their lives. Thousands of ABA providers work with children and
A solo practitioner spends 15 hours every week on billing. Checking insurance. Submitting claims. Posting payments. Calling about denials. Following up on aged accounts. Dealing
A billing clerk receives a phone call. Someone claims to be a patient’s daughter asking about her mother’s recent hospital bill. The clerk pulls up
A patient walks into a clinic with knee pain. The doctor orders an MRI. The imaging center performs the scan. The radiologist reads it. The
Pre-authorization is approval from an insurance company that must be obtained before a medical service is provided. Without this approval, the insurance company can deny
What Is a Third-Party Payer and Why It Matters When a patient goes to a doctor, someone has to pay for that visit. Most of
Medical billing works differently depending on which type of insurance a patient has. Private insurance, Medicare, and Medicaid each have their own rules, payment rates,
