Decode Billing Challenges
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October 27, 2025

If you’ve been in medical billing long enough, you’ve probably had that frustrating moment — a claim gets denied, you check the EOB, and there it is: CO-252 staring back at you. This one doesn’t say “not covered” or “invalid code.” It says something even more annoying: “An attachment or other documentation is required to […]

October 22, 2025

If you’ve been in healthcare billing for even a short while, you’ve probably seen Modifier 59 pop up — often followed by a denial letter from Medicare or a commercial payer that says something like: “Services bundled per NCCI edits.” Sound familiar? That’s where Modifier 59 steps in — one of the most misunderstood, misused, […]

October 6, 2025

Wound care is one of the busiest areas in healthcare, especially for primary care clinics, wound centers, podiatry practices, and home health agencies. Providers see everything from traumatic cuts to chronic diabetic ulcers that take months to heal. However, while delivering wound care is fairly straightforward, getting paid for it can often be a headache. […]

October 1, 2025

Skin tags may be small and harmless, but when it comes to medical billing , they can cause surprisingly big headaches. Most providers are aware of the prevalence of skin tags—patients request removals every day in primary care and dermatology settings—but not every removal is billable. Payers want to know whether the procedure was medically […]

August 25, 2025

Ever wondered why it takes forever for a new doctor to start seeing patients at your clinic? Or why did your insurance company deny that perfectly valid claim? The answer lies in credentialing—the unsung hero of healthcare administration. Think of it as a super-rigorous background check that ensures providers are qualified to practice and get […]

August 17, 2025

Consider you’ve just finished seeing a patient for a follow-up on hypothyroidism. Labs are stable, meds are adjusted, and your EHR auto-fills “E03.9 – Hypothyroidism, unspecified.” You click submit, move on with your day… and a few weeks later, the claim comes back denied. Sound familiar? Hypothyroidism is one of the most common endocrine disorders […]

August 14, 2025

Billing for psychotherapy isn’t just about putting numbers on a claim form—it’s about selecting the correct CPT codes to reflect the service provided accurately. Whether you’re a psychologist, psychiatrist, social worker, or counselor, correct coding ensures you get reimbursed properly and stay compliant with payer requirements. This guide walks you through the main psychotherapy CPT […]

August 7, 2025

If your practice bills Medicare for services provided by non-physician practitioners (NPPs) — like nurse practitioners, physician assistants, or clinical nurse specialists — then you’ve probably heard of “incident-to” billing. But let’s be honest, the rules around it aren’t exactly easy reading. One missing signature or documentation error, and you’re looking at denied claims, audits, […]

July 30, 2025

When a healthcare provider submits a claim, and the insurance payer processes it, the first thing the provider (and often the patient) receives isn’t always the payment—it’s the EOB, or Explanation of Benefits. If you’ve ever been confused by it, you’re not alone. Let’s break it down together—what EOB means, what it includes, how to […]

July 16, 2025

In the world of healthcare, accurate billing is essential for maintaining a healthy revenue cycle. One crucial aspect of medical billing is understanding the Place of Service (POS) codes, which define where medical services are provided. Among the various POS codes, POS 11 plays a vital role in healthcare billing. As part of Medix Revenue […]

July 8, 2025

Medical claim denials can significantly impact medical practices’ revenue growth. When an insurance payer denies a medical claim, it returns the claim form to the provider and explains the reasons for the denial. These reasons are usually indicated shortly in the form of codes, which are usually known as denial codes in medical billing. Healthcare […]

June 17, 2025

Charge posting refers to the process of entering billing codes and associated charges into the medical billing system after a patient visit. It typically begins with a superbill a document containing diagnosis codes, procedure codes, and provider details. From there, the information is reviewed and submitted by the charge entry team to generate claims for […]