Answers to the Billing Problems Costing You Revenue.
Guides written for practice owners and office managers dealing with denials, slow payments, and billing team turnover. No textbook theory -- just what works.
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What Is in the MedPrecision Resources Library?
The Resources hub is a working library of 109 long-form medical billing guides written for practice owners and office managers actively dealing with denials, slow A/R, credentialing gaps, and vendor evaluation. Categories include denials and A/R, revenue cycle optimization, practice operations, compliance and credentialing, and outsourcing and vendor selection. Each guide is fact-checked against MGMA, HFMA, AAPC, CMS, and HBMA published references rather than vendor-marketing claims, with citation-ready answers and decision frameworks rather than generic advice.
- 109+ practitioner-grade guides across 5 categories
- Sourced from MGMA, HFMA, AAPC, CMS, HBMA references
- Decision frameworks for vendor selection + transitions
- Updated to track CPT, NCCI, and PFS rule changes
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The guides practice owners and office managers read most -- because choosing, pricing, and switching billing companies are the decisions that cost the most revenue.
How to Switch Medical Billing Companies Without Revenue Loss
How to switch medical billing companies without losing revenue — including whether you have to change billing software. Step-by-step transition plan.
Read the GuideThe Medical Billing RFP and Transition Process
After you have a shortlist: the one written scope to send every vendor, the contract terms to settle before signing, and a 120-day transition plan measured against your own baseline.
Read the GuideHow Much Do Medical Billing Companies Charge in 2026? Complete Pricing Guide
Medical billing cost, sourced: what share of billing companies charge under 5%, 5-8% or 10%+, per-claim quotes, setup fees, and the contract terms to check.
Read the GuideBest Medical Billing Companies (2026): Names and Published Prices
Thirteen medical billing and outsourcing companies, each with the price it publishes on its own site, read 17 Sep 2026: 2.9%, 4–8%, 7.0% — or “Not published”. Plus who writes the “best” lists and where they place themselves.
Read the GuideThe Benefits of Outsourcing Medical Billing in 2026 (Honest ROI Analysis)
Seven real benefits of outsourcing medical billing, with worked ROI arithmetic you can re-run on your own numbers, plus four scenarios where in-house is right.
Read the GuideAll 109 guides by category
No guides match that title. Try a different word, or browse the categories above.
Denials & A/R
View all Denials & A/R guides97 Denial Code Explained: What It Means and How to Fix It
CARC 97 means the service is bundled into another procedure. Learn what triggers it (NCCI PTP edits), the modifier 59/X-modifier fix, and when to appeal.
Read the GuideBCBS Denial Codes List: BlueCard, Prefixes & How to Fix Each (2026)
BCBS denial codes map to standard X12 CARC/RARC values. Decoder tables for common Blue Cross Blue Shield denials, BlueCard routing, and the alpha-prefix fix.
Read the GuideCARC and RARC Codes: Denial Codes Reference
CARC and RARC reference: what each listed code means in plain language, its X12 status, the operational fix, and when a PR code may be billed.
Read the GuideCardiology Denial Cheat Sheet: Top CARC Codes, Causes, Fixes, and Appeal Angles
The top cardiology billing denials by CARC code — cath-lab bundling (97/236), stress-test supervision, echo downcoding, prior auth (197) — each with the fix and appeal angle.
Read the GuideCO-236 Denial Code: NCCI Compatibility Meaning & How to Fix It
CO-236 means a procedure/modifier combo is not NCCI-compatible. Learn the Modifier Indicator 0/1/9 fix, when to add modifier 59/X, and when to write off.
Read the GuideDays in A/R: Formula, Benchmark, and How to Reduce It
Days in A/R benchmark: AAFP says stay below 50 days, 30–40 preferable. Get the formula, how to read your aging buckets, and the 4 levers that lower it.
Read the GuideN822 & N823 Remark Codes: Missing or Invalid Modifier — How to Fix
N822 means a missing procedure modifier; N823 means an invalid one. Learn the CO-16 + N822 fix, the modifier-by-specialty triggers, and how to resubmit.
Read the GuidePR-227 Denial Code: What It Means and How to Fix It (2026)
PR-227 means info the payer requested from the patient wasn't provided. COB and other-insurance causes, how to get them to respond, plus PR-31 vs CO-16.
Read the GuideDenial Rate by Specialty (2026): What Actually Drives Denials in Each One
The only free specialty-group denial rates we found are MGMA's 2019-2020 figures. What drives denials in each specialty, with CMS and eCFR citations.
Read the GuideDermatology Billing Benchmarks (2026): KPIs, Denial Rates & Targets
Dermatology billing benchmarks for 2026: the freely published physician-practice figures, the ones that do not exist, and the top derm CARC denials and fixes.
Read the GuideMedical Billing Denial Benchmarks 2026: The Evidence Ledger
MGMA puts first-submission denials at 7% to 8%; AAFP calls 5% to 10% average. HFMA's formulas, plus hospital and payer-side rates with sources.
Read the GuideUrgent Care Denial Cheat Sheet: CARC 4, 97, 16, 197 and 45 Causes, Fixes and Appeal Angles
The CARC codes to check first on an urgent care denial: POS 20 vs 11, modifier 25 on bundled E/M, S-code routing and auth, with the fix and appeal angle.
Read the GuideAppeal Letter Template for Medical Billing (with Examples)
How to write a medical billing appeal letter: what the payer requires versus recommended structure, three templates by denial type (CARC 50, 197, 97), and the Medicare appeal levels and deadlines.
Read the GuideB7 Denial Code: Provider Not Certified for This Service — How to Fix It (2026)
B7 means the provider wasn't certified/eligible to be paid for this service on this DOS. Causes, the PECOS/credentialing fix, and a B7 vs CO-185 vs CO-8 table.
Read the GuideClean Claim Rate Formula and Measurement (2026)
How to calculate clean claim rate on one measurement event and one denominator, why no free primary source publishes a target, and the nine levers that move it.
Read the GuideClearinghouse Rejection vs Payer Denial: The Critical Distinction
Why a rejection is not a denial, which layer produced it, what Medicare says about appeal rights on returned claims, and how the 277CA tells them apart.
Read the GuideCO-129 Denial Code: What It Means and How to Fix It (2026)
CO-129 means prior processing info appears incorrect — usually a corrected claim filed without frequency code 7 or the right original claim number. The fix.
Read the GuideCO-A1 Denial Code: What It Means and How to Fix It (2026)
CO-A1 means the claim/service is denied and at least one Remark Code must be provided. The real reason lives in the paired RARC. Decoder table + fix workflow.
Read the GuideDenial Management in Healthcare: Complete Guide with CARC Code Reference
Denial management, worked from primary sources: the rejection-versus-denial line Medicare draws, 25 CARC codes with corrected meanings, the six-step workflow, and the appeal clocks in the CFR.
Read the GuideHow to Improve Clean Claim Rate
Fix claims before submission, not after denial: the front-end, scrubbing and feedback disciplines that raise acceptance into adjudication — with owners and a 30/60/90 plan.
Read the GuideHow to Recover Aged A/R
Aged A/R is a triage problem, not an age problem. How to sort legacy claims by filing deadline, appeal rights, denial cause, balance and cost to work — and what to write off.
Read the GuideHow to Reduce Claim Denials
Five disciplines that prevent claim denials: eligibility, prior auth, coding, scrubbing and weekly root-cause review — plus how to measure your own baseline.
Read the GuideMental Health Billing Denials Cheat Sheet: CARC Codes, Causes, Fixes, and Appeal Angles
The top mental health billing denials in one reference: CARC code, plain-English cause, code/modifier context, the operational fix, and the appeal angle for each.
Read the GuideNet Collection Rate vs Gross Collection Rate: The Real Difference
Why gross collection rate misleads, what net collection rate actually measures, both formulas, the one published target with a real source, and how to compute it.
Read the GuideOrthopedic Denial Cheat Sheet: Top CARC Codes, Causes, Fixes and Appeal Angles (2026)
The top orthopedic billing denials by CARC code - global-period 97, prior-auth 197, NCCI 236, info-missing 16 - each with the cause, the correct modifier, the fix and the appeal angle.
Read the GuidePhysical Therapy Denial Cheat Sheet: Top PT Denials by CARC Code, Cause, Fix, and Appeal Angle
The top physical therapy billing denials by CARC code — 97140+97530 bundling (CARC 97/236), missing GP/KX modifiers, auth gaps (197) — with the fix and appeal angle for each.
Read the GuidePR-27 Denial Code: Expenses After Coverage Terminated — How to Fix It
PR-27 is the CARC for a service billed after the plan's coverage ended. Causes, the re-verify-and-rebill fix, PR-27 vs PR-26 vs CO-27, and an appeal template.
Read the GuidePR-95 Denial Code: Plan Procedures Not Followed — How to Fix It
PR-95 means a required plan step was missed: no referral, no prior auth, or out-of-network. The fix, retro-auth, and when you can bill the patient.
Read the GuideWhat Is A/R in Medical Billing? Days in A/R, Aging Buckets, and How to Manage Them
A/R in medical billing explained: the days-in-A/R calculation, aging buckets (0-30, 31-60, 61-90, 90+), the AAFP target and what no free source publishes.
Read the GuideA/R Aging Report in Medical Billing: How to Read It and Work Every Bucket (2026)
An A/R aging report sorts unpaid claims by 0-30, 31-60, 61-90, 91-120, 120+ days. Target under 25% of A/R over 90. Bucket table, worked example, playbook.
Read the GuideCO-29 Denial Reason: Timely Filing Limit Expired — How to Fix It
CO-29 denial reason: the time limit for filing has expired. See timely filing limits by payer, appeal-winning exceptions, and a copy-paste appeal template.
Read the GuideCO-16 Denial Code: What It Means and How to Fix It (2026)
CO-16 means the claim lacks information needed for adjudication. The fix lives in the paired RARC. Decoder table for N822, M51, N290, N382 and how to fix each.
Read the GuideCO-22 Denial Code: Coordination of Benefits — How to Fix It
CO-22 means care may be covered by another payer per coordination of benefits. Learn the COB-order causes, the bill-primary-first fix, and the appeal steps.
Read the GuidePR-1, PR-2, PR-3 Patient Responsibility Codes: Deductible, Coinsurance & Copay Explained
PR-1 = deductible, PR-2 = coinsurance, PR-3 = copay. What each means, when to bill the patient, and when NOT. Side-by-side table plus the statement workflow.
Read the GuidePR-31 Denial Code: Patient Cannot Be Identified as Our Insured — How to Fix It
PR-31 / CARC 31 means the patient cannot be identified as the payer's insured. Learn the causes (wrong member ID, name mismatch, wrong payer) and the fix.
Read the GuideRevenue Cycle Optimization
View all Revenue Cycle Optimization guidesColonoscopy CPT Codes 45378-45385: Screening vs Diagnostic Billing (2026)
45378 diagnostic, 45380 biopsy, 45384/45385 polyp removal, G0105/G0121 screening. Modifier 33 vs PT, the screening-turned-diagnostic cost trap, and denials.
Read the GuideEFT vs Paper Check Payer Payments: Why Every Practice Should Convert
How payer EFT actually works, what the HIPAA-adopted CCD+ and TRN standards do and do not require of your bank, the CORE reassociation clocks, and how to run an EFT/ERA status register.
Read the GuideHome Health CPT & HCPCS Codes: The 2026 Billing Reference
Home health billing runs on HCPCS G-codes, not CPT — G0299/G0300, G0151-G0153, the PDGM 30-day claim, plus home E/M 99341-99350 and CPO. Full code table inside.
Read the GuideMedicare Physician Fee Schedule Conversion Factor: History, 2026 Rates, and Impact by Specialty
The Medicare PFS conversion factor CY2020-CY2027, both 2026 rates ($33.57 / $33.40), the CY2027 proposed $33.17 / $32.84, and what it does to individual codes.
Read the GuidePayment Posting in Medical Billing: ERA, Reconciliation & KPIs (2026)
Payment posting records every payment, adjustment and denial against a claim: ERA (835) vs manual EOB posting, reconciliation, and the accuracy KPI band.
Read the GuideSpecimen Handling 99000 & 99001 Billing: When It's Payable (2026)
CPT 99000 and 99001 bill specimen handling. Medicare bundles both (status B). See when commercial payers reimburse 99000, plus the 99000 vs 36415 table.
Read the GuideMedical Billing KPI Dashboard Template (2026)
The 12 KPIs every billing dashboard should track, their formulas, which targets are actually published, and the layout that surfaces problems early.
Read the GuideERA vs EOB: The Real Difference Explained
ERA (X12 835 electronic remittance) vs EOB (patient explanation of benefits) — what each contains, who receives them, and why providers should rely on ERA.
Read the GuideG2211 Add-On Code Explained: When and How to Bill It
G2211 (visit complexity inherent to E/M) — what CMS covers, when it applies, the documentation that supports it, and the 2024 activation for primary care.
Read the GuideThe Medical Billing Process Step-by-Step (2026 Complete Guide)
The medical billing process from scheduling to final payment: 12 steps, who owns each one, the failure mode at every stage, and which timings are actually published.
Read the GuidePhysical Therapy CPT Codes: Cheat Sheet & Reimbursement Reference
Physical therapy CPT codes reference. Eval 97161-97164, treatment 97110/97112/97140/97530, modalities, 8-Minute Rule math, and KX modifier triggers.
Read the GuideRevenue Cycle Management Best Practices for 2026: The Complete Operational Playbook
10 revenue cycle management best practices for medical practices and hospitals — eligibility, charge-entry lag, denial triage, A/R aging — plus a 90-day rollout plan.
Read the GuideUB-04 Revenue Codes Explained: FL 42, HCPCS Pairing & Common Codes (2026)
UB-04 revenue codes (FL 42) classify each charge by department. Common-codes table, how to pair HCPCS in FL 44, bill types in FL 4, and UB-04 vs CMS-1500.
Read the GuideWhat Is RCM in Medical Billing? Complete 2026 Guide to Revenue Cycle Management
Revenue cycle management (RCM) explained: 12 stages from scheduling to collections, the 6 KPIs that matter, which targets are published and which are not.
Read the GuideOncology Billing CPT Codes: Chemo Administration, Drugs & Modifiers
How oncology billing works: the chemo admin hierarchy (96413/96415/96417), Part B drugs at ASP+6%, and the JW/JZ modifiers that deny claims.
Read the Guide90834 vs 90837: Psychotherapy Billing, Time Rules & 2026 Rates
90834 bills 45-minute psychotherapy (38-52 min); 90837 bills 60 minutes (53+ min). See the 38-minute threshold, 2026 CMS rates, and how to defend 90837.
Read the GuideABA Billing Codes 97153 & 97155: Units, Rules & Denials (2026)
ABA CPT 97153 (technician treatment) and 97155 (QHP protocol modification): 15-minute units, concurrent-billing rules, auth tracking, and denial fixes.
Read the GuideG0438 vs G0439: Annual Wellness Visit Billing Guide (2026)
G0438 is the initial Medicare AWV (once per lifetime); G0439 is every subsequent AWV (annual). The difference, 2026 rates, vs IPPE G0402, and denial fixes.
Read the GuideKnee Arthroscopy Billing (29881, 29880, 27447): Codes, Modifiers & Denials (2026)
29881 (1-compartment meniscectomy) vs 29880 (2-compartment) vs 27447 (TKA). Modifier 50/RT/LT/59 rules, 90-day globals, CMS PFS rates & top denials.
Read the GuideOB Global Package Billing: 59400, 59510, 59610 & When to Unbundle (2026)
OB global codes 59400 (vaginal), 59510 (cesarean), 59610 (VBAC) bundle antepartum, delivery & postpartum. Learn what's included, when to unbundle & code rates.
Read the GuidePALTC Revenue Cycle Management: A 2026 Operating Guide (SNF, ALF, LTC)
PALTC RCM explained: SNF triple-check, PDPM/MDS, consolidated billing, Part A vs B, Medicaid room-and-board vs ancillary, plus 2026 KPI benchmark bands.
Read the GuidePodiatry CPT Codes Cheat Sheet: Routine Foot Care, Q Modifiers & Surgery (2026)
Podiatry CPT cheat sheet: routine foot care (11055-11057, 11719-11721, G0127), Q7/Q8/Q9 class-finding modifiers, at-risk dx coverage, and 28xxx surgical codes.
Read the GuideUrgent Care Billing Codes S9083 & S9088: Requirements, Rates & Denials (2026)
S9083 is a flat global case rate; S9088 is an add-on billed WITH an E/M. Learn which payers mandate each, POS 20 rules, and how to fix common denials.
Read the GuideChronic Care Management Billing (CPT 99490): The Complete Rules
CPT 99490 Chronic Care Management requirements: two chronic conditions, 20 minutes monthly, the consent rule, the care plan, and related codes 99439, 99487,.
Read the GuideElectronic Claim Submission vs Paper: The Real Comparison
Why electronic claim submission via X12 837 beats paper CMS-1500: HIPAA standards, the ASCA rule, processing time differences, and when paper still applies.
Read the GuideTransitional Care Management Billing (CPT 99495 and 99496)
CPT 99495 and 99496 explained — the 2/7/14-day TCM contact rules, 2026 reimbursement rates, documentation traps, and why TCM claims get denied. Full guide.
Read the GuideWhy Mental Health Practices Lose Revenue in Billing
Mental health practices lose revenue to credentialing gaps, auth errors and time-code mistakes. The five patterns, and the operational fix for each.
Read the GuideCompliance & Credentialing
View all Compliance & Credentialing guidesCMS-588 EFT Authorization: The Signer Rule and Everything Else
CMS-588 authorizes Medicare EFT — it is not enrollment. The same AO/DO on your CMS-855 must sign it. When you need one, bank-document rules, PECOS vs mail.
Read the GuideCMS-855B: How an Organization Enrolls in Medicare
Form CMS-855B enrolls clinics and group practices in Medicare. Who files it vs 855A/855I, why physician groups skip the $750 fee, and what MACs reject.
Read the GuideCMS-855I: What the Form Itself Requires, Section by Section
CMS-855I enrolls physicians and NPPs in Medicare and now carries every reassignment. Form selector vs 855B/855O, walkthrough, MAC timeframes, fee rules.
Read the GuideCMS-855R Discontinued: How Medicare Reassignment Works Now
CMS discontinued the CMS-855R on October 31, 2023. All reassignment actions now run through CMS-855I or PECOS. The post-2023 workflow, quoted from CMS.
Read the GuideInsurance Credentialing for Therapists: Who Credentials You at Each Payer
Who credentials therapists at Cigna, Aetna, UnitedHealthcare, Elevance and Medicare, what each publishes about timing, and what it does not.
Read the GuideMedicare PTAN: What It Is, Who Issues It, and How to Find Yours
A PTAN is the Medicare-only number your MAC issues at enrollment approval. PTAN vs NPI vs MBI, recovering a lost PTAN, and the deactivation rules.
Read the GuideMedicare Revalidation: The Operational Playbook CMS Doesn't Publish in One Place
Find your Medicare revalidation due date, revalidate in PECOS, avoid deactivation. The 5-year cycle, 7-month rule and $750 CY2026 fee, all CMS-cited.
Read the GuidePECOS Enrollment: Step-by-Step Guide for Providers (2026)
PECOS enrollment step by step: which 855 form to file (855I or 855B — 855R discontinued), reassignment via the 855I, revalidation, and effective dates.
Read the GuidePOS 13 in Medical Billing: Assisted Living Facility Code Explained (2026)
POS 13 = Assisted Living Facility, paid at the non-facility rate. Who bills it, E/M codes 99341-99350, POS 12/14/31/32/33 compared, and common denials.
Read the GuideAmbetter Provider Credentialing: How to Join by State
Ambetter has no national credentialing application. Eight verified state plan routes, CAQH and document rules from the 2026 manuals, and response windows.
Read the GuideCigna Provider Credentialing: How to Join the Network
How Cigna credentialing starts, the CAQH status it asks for, Evernorth's behavioral application routes and the dental path. Cites Cigna and Evernorth.
Read the GuideCAQH ProView Is Now the CAQH Provider Data Portal (2026 Guide)
CAQH ProView is now the CAQH Provider Data Portal: how it works, the 120-day attestation cycle (180 days in Illinois), and what it does not replace.
Read the GuideEPSDT Medicaid Billing for Children: The Federal Rules
Medicaid EPSDT billing for pediatric well-child visits: the federal floor, why the state periodicity schedule governs, the EP modifier, VFC vaccine lines, and a dated state-by-state matrix.
Read the GuideGood Faith Estimate Requirements Under the No Surprises Act (2026)
Good Faith Estimates for uninsured and self-pay patients: the timing clocks, all eleven required elements, the open-ended co-provider enforcement discretion, and the $400 dispute threshold.
Read the GuideHIPAA Compliance in Medical Billing: Complete 2026 Guide for Practices and Vendors
HIPAA compliance for medical billing: BAA checklist, three rules (Privacy, Security, Breach Notification), minimum necessary standard, and how to vet a vendor.
Read the GuideMedical Billing Audit Checklist (2026): 47 Items to Review
47-item billing audit checklist: coding accuracy, documentation, denial trends, KPIs, compliance, and revenue leak detection — the first-engagement framework.
Read the GuideMedical Coding Audits: A Buyer's Guide (2026)
What a coding audit is: prospective vs retrospective, random vs focused, what OIG and CMS actually publish on sampling and monitoring, and how audit scope and pricing are structured.
Read the GuideMedicare Incident-To Billing Rules (2026)
Medicare incident-to rules as the regulation now reads: the nine conditions in 42 CFR 410.26, virtual direct supervision, the general-supervision exceptions, and a per-encounter eligibility check.
Read the GuideModifier 59 vs X-Modifiers (XE, XS, XP, XU): The 2026 Picture
How modifier 59 and the X modifiers (XE, XS, XP, XU) work, when CMS requires the X modifiers, and the NCCI edit logic that drives bundling reversals.
Read the GuidePayer Credentialing Timeline and Cost (2026)
Credentialing, contracting, enrollment and effective dates are four separate gates. What each one controls, what the rules actually say, what it costs, and how to track it.
Read the GuideProvider Enrollment Checklist (2026): 32 Items and When Each Applies
A 32-item provider enrollment checklist for Medicare, Medicaid and commercial payers — each item marked Required, If applicable, or Not required by payer.
Read the GuideType 2 NPI: Which Entities Need One and How NPPES Assigns It
Sole proprietor, single-member LLC, S-corp or group — the CMS-sourced entity table, the CP-575 legal-name match, and the free NPPES application, quoted.
Read the GuidePOS 02 vs POS 10: Telehealth Place of Service Codes Explained (2026)
POS 10 is telehealth in the patient's home (higher non-facility rate); POS 02 is telehealth elsewhere (lower facility rate). Rate table, payer rules and fixes.
Read the GuideModifier 25: When to Use It (and When You Can't)
AMA CPT modifier 25 rules: when an E/M is significant and separately identifiable, the OIG audit triggers, audit-proof documentation, and common procedures.
Read the GuidePlace of Service Codes: POS 11 vs POS 22 (and the Others That Matter)
POS 11 (office) vs POS 22 (on-campus outpatient hospital) and the reimbursement difference, plus POS 02/10 telehealth and patterns that produce POS denials.
Read the GuidePractice Operations
View all Practice Operations guidesMedical Billing for Group Practices
How group practices can improve revenue cycle performance, reduce overhead, and improve collections with MedPrecision's specialized billing services.
Read the GuideMedical Billing for New Practices
Starting a new practice? The 90-day medical billing playbook: credentialing timeline, payer enrollment, fee schedules, software, and cash forecast.
Read the GuideThe Prior Authorization Process Explained (2026)
How prior authorization works: payer requirements, the 278 transaction, CMS Final Rule timelines, common denials (CARC 197), and operational steps.
Read the GuideMedi-Cal Billing Guide: Managed Care Models, Share of Cost, TARs & Timely Filing (2026)
Medi-Cal billing: the five DHCS managed care models, share of cost, TARs, and the six-month filing rule with its 75% and 50% reduced-payment windows — sourced to DHCS.
Read the GuideMedical Billing for Telehealth Providers
Telehealth billing in 2026: POS 02 vs POS 10, modifier 95 rules, and the 98008-98016 audio-only codes that replaced the deleted 99441-99443.
Read the GuideSuperbill Template for Therapy: Free Printable Sample (2026)
A filled, printable therapy superbill template with NPI, ICD-10, CPT 90791/90834/90837/90847, units, fees, POS — plus how a client claims reimbursement.
Read the GuideMedical Billing vs Medical Coding: What's the Difference?
Coders translate documentation into ICD-10/CPT/HCPCS; billers turn codes into paid claims. Daily tasks, certifications, salaries, and how the roles differ.
Read the GuideWhat Is a Superbill in Medical Billing?
A superbill is the itemized form a provider gives a patient or payer with CPT, ICD-10, and HCPCS codes. What's on it, when it's used, and how it differs from.
Read the GuideMedical Billing for Multispecialty Practices
Multispecialty billing requires per-specialty coders, separate fee schedules per payer-specialty, and KPI dashboards by department. The operational playbook.
Read the GuideOutsourcing & Vendors
View all Outsourcing & Vendors guidesHow Much Do Medical Billing Companies Charge in 2026? Complete Pricing Guide
Medical billing cost, sourced: what share of billing companies charge under 5%, 5-8% or 10%+, per-claim quotes, setup fees, and the contract terms to check.
Read the GuideRCM Outsourcing vs Internal Team
Outsourced RCM vs an internal team: a like-for-like worksheet built on published wage and benefit data, our own published rates, and the benchmarks that do not exist.
Read the GuideHow to Switch Medical Billing Companies Without Revenue Loss
How to switch medical billing companies without losing revenue — including whether you have to change billing software. Step-by-step transition plan.
Read the GuideBest Medical Billing Companies (2026): Names and Published Prices
Thirteen medical billing and outsourcing companies, each with the price it publishes on its own site, read 17 Sep 2026: 2.9%, 4–8%, 7.0% — or “Not published”. Plus who writes the “best” lists and where they place themselves.
Read the GuideThe Medical Billing RFP and Transition Process
After you have a shortlist: the one written scope to send every vendor, the contract terms to settle before signing, and a 120-day transition plan measured against your own baseline.
Read the GuideMedical Billing Vendor Evaluation Scorecard: 27 Weighted Criteria to Score Before You Sign
A weighted 27-criterion scorecard to evaluate medical billing vendors. Score each 0/1/2, total out of 100, plus red-flag auto-disqualifiers and a worked example.
Read the GuideOutsource Insurance Eligibility Verification
What a 270/271 eligibility check does and does not return, the two depths of verification, how to evaluate a vendor, and a break-even worksheet you run on your own numbers.
Read the GuideWhat PT Practices Should Check Before Outsourcing Billing
PT practices face the CY 2026 Medicare therapy threshold ($2,480), the KX modifier and 8-Minute Rule unit math. The 12 things to verify before outsourcing.
Read the GuideThe Benefits of Outsourcing Medical Billing in 2026 (Honest ROI Analysis)
Seven real benefits of outsourcing medical billing, with worked ROI arithmetic you can re-run on your own numbers, plus four scenarios where in-house is right.
Read the GuideOutsource Prior Authorization
AMA data: practices spend 13 hours/week per physician on prior auth. Outsourcing PA: typical pricing, ROI math, vendor evaluation criteria, and risks to manage.
Read the GuideFree Billing Audit · No obligation
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