If you searched “Humana timely filing limit” expecting a single number, here’s the problem: there isn’t one. Humana runs Medicare Advantage, state Medicaid managed care, and TRICARE East under three completely different regulatory frameworks, and each one sets its own claims deadline. Depending on the plan sitting in front of you, that window could be […]
Read MoreIf you bill for Aetna and you’ve ever watched a clean, medically necessary claim get denied for one reason and one reason only you already know how frustrating a CO-29 timely filing denial can be. There’s no coding error to fix, no missing documentation to chase down. The service was legitimate, the patient was eligible, […]
Read MoreIf you run a medical practice, you already know the feeling: you’ve delivered the care, your staff has submitted the claim, and now you’re just… waiting. Weeks pass. Then months. Meanwhile payroll, rent, and supply orders don’t wait for anyone. This waiting period has a name in medical billing Days in Accounts Receivable (A/R) and […]
Read MoreIf you run a medical practice, you already know the feeling: claims go out, some money comes back, and somewhere in between a chunk of your revenue just… disappears. No dramatic event causes it. It leaks out slowly, through small inefficiencies that are easy to miss unless you’re measuring them. That’s exactly what KPIs (Key […]
Read MoreEvery healthcare practice runs on two things: good patient care and a billing process that actually gets paid for it. Yet most providers only think about their medical billing process when something goes wrong a spike in denials, a cash flow crunch, or a payer audit that exposes gaps nobody noticed until it was too […]
Read MoreIf you’ve ever looked at a patient statement or an insurance Explanation of Benefits (EOB) and wondered what those five-digit numbers next to each service mean, you’ve already encountered CPT codes in medical billing. These codes are the invisible infrastructure behind every office visit, lab test, surgery, and vaccination billed in the United States healthcare […]
Read MoreA denied claim is never just a paperwork problem. It’s a hole in your practice’s cash flow that someone on your team has to notice, investigate, correct, and resubmit usually while three other tasks are waiting in line. Multiply that by dozens of denials a week, and it’s easy to see why revenue cycle leaders […]
Read MoreOncology billing has one of the highest error rates in medical coding, and chemotherapy CPT codes sit at the center of most of it. A single infusion visit can generate five or six billable lines an administration code, one or more add-on codes, a drug line, a wastage modifier, and sometimes an E/M code and […]
Read MoreEnrolling as a healthcare provider with Alabama Medicaid is more complex than most practitioners realize. While the state’s electronic portal operated by Gainwell Technologies appears straightforward on the surface, missing a single step or misunderstanding a new 2026 requirement can delay your billing by months or even result in denial of enrollment altogether. This comprehensive […]
Read MoreGetting credentialed with an insurance company in Pennsylvania is rarely a one-form process. Depending on where your practice sits, you may need separate applications with two or more Blue Cross Blue Shield licensees, a regional health plan like UPMC or Geisinger, and Pennsylvania’s Medicaid program through Promise before you’ve even touched Medicare. For a solo […]
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