Introduction Claim denials are one of the biggest headaches for providers, but with the right processes in place, they can be significantly reduced. Main Strategies 1. Accurate Eligibility Verification – Always verify insurance coverage before every visit 2. Clean Claim Submission – Use correct codes, modifiers, and POS 3. Timely Filing – Never miss payer […]

Introduction Telehealth is growing rapidly, but billing errors and payer policy differences often cause providers to lose revenue. Main Challenges Modifier Use: 95, GT, FQ, FR – incorrect use leads to denials POS Codes: 02 (Telehealth), 10 (Telehealth – patient home) – wrong selection is a common issue State-Specific Rules: Maryland vs. DC payers often […]

Introduction Provider credentialing is the process of getting enrolled with insurance companies so you can receive payments. Delays in credentialing can directly impact your revenue. Impact of Credentialing Delays No Payments: Until credentialing is complete, claims may be denied Conclusion Every month of credentialing delay can cost practices thousands in lost revenue. MedProAlign ensures smooth […]

Introduction Medical billing and coding are often used interchangeably, but they are two distinct parts of the revenue cycle. Both are essential for accurate reimbursement. Medical Coding Assigns ICD, CPT, and HCPCS codes to diagnoses and procedures Ensures compliance with payer guidelines Provides the “language” insurance companies understand Medical Billing Uses codes to create and […]

Introduction Claim denials are one of the biggest challenges in medical billing. They delay payments, hurt cash flow, and increase administrative work. The good news? Most denials are preventable. Common Reasons for Claim Denials 1. Incorrect Patient Information – Small errors in name, DOB, or insurance ID can lead to rejections. Fix: Verify patient eligibility […]