Denial Management
Denial Management Best Practices for Medical Practices
Generic denial workflows miss the point. Here are denial management best practices organized by the actual reason a claim was denied.
Resources
RCM University
Educational lessons on revenue cycle and care management fundamentals.
Denial Management
Medical Claim Rejection vs. Denial: What's the Difference?
A rejection and a denial are not the same event. Here's a clear, side-by-side breakdown of the difference, with examples and how each is typically resolved.
Medical Billing Outsourcing
How to Choose a Medical Billing Company: Questions to Ask
A concrete list of questions to ask a prospective medical billing company, organized by topic, plus red flags to watch for during vendor evaluation.
Medical Billing Outsourcing
How Much Does Medical Billing Outsourcing Cost?
A plain-English breakdown of how medical billing outsourcing is commonly priced, what drives the cost, and how to compare quotes from different vendors.
Medical Billing Outsourcing
In-House vs Outsourced Medical Billing: A Practice Owner's Comparison
A side-by-side look at how in-house and outsourced medical billing differ on staffing, oversight, reporting, technology, scalability, and cost structure.
Claims & Billing Operations
What Is Payment Posting in Medical Billing?
A plain-language explanation of payment posting in medical billing: what it is, why accuracy matters, and how it connects to A/R and collections metrics.
Claims & Billing Operations
Insurance Eligibility Verification Checklist
A working checklist for insurance eligibility verification, with each item tied to the specific claim rejection or denial it is designed to prevent.
Claims & Billing Operations
Medical Claims Submission Checklist
A step-by-step checklist practices can use to review a claim's completeness and accuracy before it goes out the door, reducing avoidable rejections and denials.
Revenue Cycle & Accounts Receivable
How to Improve Medical Practice Collections
Collections performance isn't only about claims and A/R — it starts with how a practice communicates balances to patients and collects at the point of service. A front-office-focused guide for administrators and billing leaders.
Revenue Cycle & Accounts Receivable
Medical Billing KPIs Every Practice Should Track
Four core medical billing KPIs, defined with exact numerators and denominators — plus outstanding A/R, underpayment visibility, collection trends, and payer performance — and what to actually do with the numbers.
Revenue Cycle & Accounts Receivable
How to Reduce Medical Billing A/R Aging
A/R aging measures how long unpaid balances sit on the books. Here is a bucket-by-bucket framework — with the actual 90+ day calculation — for working outstanding claims down before they become write-offs.
Denial Management
How to Reduce Medical Billing Claim Denials
Denials rarely have one cause. Here's how to reduce them stage by stage across the revenue cycle, plus a simple framework for tracking denials once they happen.