Everything you need to
understand your billing.
Guides, articles, and plain-English explainers for practice owners and managers who want to understand their revenue cycle — and fix what's broken.
Deadlines, appeals & payer contacts
The tools our own billing team uses daily — timely filing deadlines for 88 payers, payer-specific appeal playbooks with free letter templates, and a provider contact directory.
Timely filing limits + deadline checker
Initial claim & appeal deadlines for 88 payers, plus a live checker that calculates your exact filing and appeal dates.
Open →Payer phone, portal & EDI directory
Provider services lines, portals, and EDI payer IDs for the payers you bill most — in one searchable table.
Open →How to appeal a UnitedHealthcare denial
The 65-day trap, the two-step reconsideration process, CDG citations, and free appeal letter templates.
Open →How to appeal an Aetna denial
The 180/60-day two-step process, Availity workflow, CPB citations, state exceptions, and free templates.
Open →How to appeal a Cigna denial
One appeal level, peer-to-peer first, NAU vs EviCore routing, Medical Coverage Policy citations, free templates.
Open →How to appeal a BCBS denial
Home-plan vs host-plan routing, the BlueCard trap, affiliate deadlines, and free appeal letter templates.
Open →How to appeal a Humana denial
The Medicare Advantage playbook — 65-day default, the auto-IRE ladder, NCD/LCD citations, free templates.
Open →CPT modifiers list (searchable)
Every modifier billers actually use — when to apply it and the classic mistake — plus a free printable cheat sheet.
Open →Modifier 25: the complete guide
The most audited code in billing — the NCCI rules, the same-diagnosis myth, and documentation that survives review.
Open →Modifier 59 & the X modifiers
NCCI edits, CCMI indicators, the 59-vs-XE/XS/XP/XU decision path, and why 40% of claims fail audits.
Open →Place of service codes (POS 02 vs 10)
The telehealth POS that decides facility vs non-facility pay, the full POS list, and the 2027 flexibility dates.
Open →E/M coding 2026: MDM vs time
99202-99215 by MDM or time, the 2026 thresholds, the 2-of-3 MDM grid, downcoding, and G2211 - plus a free quick-reference card.
Open →Global period modifiers (24, 57, 58, 78, 79)
Breaking the surgical bundle correctly - which modifier by code type and timing, plus 76/77 repeats and a free decision guide.
Open →GT vs 95 & telehealth modifiers
Why GT is retired, when 95 vs 93 vs FQ applies, and the Medicare-vs-commercial rules that cause telehealth denials.
Open →RVUs explained: how Medicare pays
The work/PE/malpractice formula, GPCI, the 2026 conversion factors, and why the same code pays differently by place and setting.
Open →CO-45 denial code explained
What it actually means, when it is not a denial at all, and the narrow cases that are genuinely worth appealing.
Read the guide →CO-97 denial code explained
The bundling decision tree most guides skip: three different bundle types, three different correct modifiers.
Read the guide →CO-50 denial code explained
Why CO-50 covers two very different things, and how to tell an unappealable exclusion from a winnable medical necessity dispute.
Read the guide →CO-11 denial code explained
A coding mismatch, not a medical necessity fight — most CO-11 denials are a same-day fix, not an appeal.
Read the guide →CO-29 denial code explained
Timely filing, and why Medicare CO-29 needs a reopening, not a standard appeal — most guides get this wrong.
Read the guide →CO-16 denial code explained
The most common denial code in billing, and a full RARC lookup table for what it actually means.
Read the guide →PR-1 denial code explained
Not actually a denial — PR-1 is a legitimate patient balance, with 2026 deductible figures and the right collection workflow.
Read the guide →Top 10 denial codes
The complete reference — what each code means, and whether it is worth fixing, billing the patient, or appealing.
Read the guide →Cardiology billing: 5 denial triggers
The exact CPT and bundling traps draining cardiology revenue — 93306 vs 93307, global vs split stress tests, and more.
Read the guide →Behavioral health: the 53-minute rule
The exact CPT time thresholds, parity rights, and 2026 SUD privacy rules driving 15-25% denial rates.
Read the guide →Orthopedic billing: modifier decisions
The exact rules for modifiers 25 vs 57, the 90-day global period trap, and the diagnosis order that makes or breaks joint replacement claims.
Read the guide →Dermatology: the measurement rule
Why measuring after anesthesia costs $12,000-$20,000 a year, plus biopsy technique coding and Mohs pathology traps.
Read the guide →Physical therapy: the 8-minute rule
The exact unit table, mixed-remainder tie-breaker, and 2026 KX threshold most guides explain incorrectly.
Read the guide →OB-GYN: the global maternity shift
Global obstetric codes are deleted Jan 1, 2027. What to do before the September 2026 payer transition deadline.
Read the guide →Urgent care: S9083 vs S9088
Two similarly-named codes that work in opposite ways — and why Medicare never accepts either of them.
Read the guide →Pediatric billing: the vaccine rule
Combination vaccines have 5-6 billable components, not 1 — plus the new 2026 counseling-only codes.
Read the guide →PECOS 2.0: what changed in 2026
The May 2026 AWS migration, mandatory MFA, and the form merger still causing rejected applications.
Read the guide →CAQH is now DataSpring
Payer-owned since January 2026, rebranded in June. What changed, and the 120-day rule that just got higher stakes.
Read the guide →How much does medical billing cost?
In-house vs outsourced — the real numbers behind the 13.7% vs 5.4% gap and what it means for your practice.
Read the guide →In-house vs outsourced billing
A clear comparison of both models — costs, risks, control, and which type of practice each is right for.
Read the guide →How to reduce claim denials
The 12.4% national denial rate is at a ten-year high. Here's what causes denials and how to systematically reduce them.
Read the guide →How long does provider credentialing take?
60 to 180 days — and every day counts. What drives the timeline, what you can control, and how to start billing sooner.
Read the guide →What is revenue cycle management?
A plain-English explanation of RCM — every step from patient registration to final payment, and why it matters more than ever in 2026.
Read the guide →Medical billing glossary A–Z
Every billing term explained in plain English — from ABN to write-off. The reference your whole team can use.
Browse the glossary →Ready to put this knowledge to work?
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