Denials & A/R resources
Guides for reducing claim denials, recovering aged accounts receivable, and improving clean claim rates so your practice gets paid faster.
97 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 Guide arrow_forwardA/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 Guide arrow_forwardAppeal Letter Template for Medical Billing (with Examples)
How to write a medical billing appeal letter that wins: required elements, three sample templates by denial type (CARC 50, 197, 97), and payer appeal levels.
Read the Guide arrow_forwardB7 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 Guide arrow_forwardBCBS 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 Guide arrow_forwardCardiology 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 Guide arrow_forwardClean Claim Rate Formula and Target Benchmark (2026)
How to calculate clean claim rate the right way, the HFMA MAP Keys benchmark, what counts as 'clean,' and the 9 process levers that move CCR from 88% to 97%.
Read the Guide arrow_forwardClearinghouse Rejection vs Payer Denial: The Critical Distinction
Why clearinghouse rejections are not denials, what happens to each, why timely filing implications differ, and how the 277CA tells the difference.
Read the Guide arrow_forwardCO-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 Guide arrow_forwardCO-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 Guide arrow_forwardCO-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 Guide arrow_forwardCO-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 Guide arrow_forwardCO-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 Guide arrow_forwardCO-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 Guide arrow_forwardCommon CARC and RARC Codes: Denial Codes Reference
Reference list of the most common CARC and RARC codes used by payers, with one-line meaning and operational fix for each. Built for denial worklists.
Read the Guide arrow_forwardDays in A/R: Formula, Benchmark, and How to Reduce It
How to calculate days in A/R, where the MGMA/HFMA benchmark really sits by specialty, aging-bucket targets, and the four levers that bring your number down.
Read the Guide arrow_forwardDenial Management in Healthcare: Complete Guide with CARC Code Reference
Complete denial management guide: top 25 CARC codes with fixes, the 6-step workflow, appeal templates, and how practices drop denial rates below 5%.
Read the Guide arrow_forwardDenial Rate by Specialty (2026): Where the Real Numbers Sit
Initial denial rates by specialty — primary care, behavioral health, surgical, OB-GYN, radiology, dermatology — and the top denial driver for each (MGMA/AAPC).
Read the Guide arrow_forwardDermatology Billing Benchmarks (2026): KPIs, Denial Rates & Targets
Dermatology billing benchmarks for 2026: clean claim rate, denial rate, days in A/R, and net collection rate bands, plus top derm CARC denials and fixes.
Read the Guide arrow_forwardHow to Improve Clean Claim Rate
A high clean claim rate means faster payments and fewer denials. Learn actionable strategies to improve your first-pass claim acceptance rate with MedPrecision.
Read the Guide arrow_forwardHow to Recover Aged A/R
Aged A/R collection probability drops below 50% past 90 days, below 30% past 120. Recovery workflow: triage, payer escalation, and the appeal queue.
Read the Guide arrow_forwardHow to Reduce Claim Denials
Claim denials cost practices 5-10% of revenue. Five-step prevention workflow with the front-end checks, coding rules, and KPIs that drop denial rate below 5%.
Read the Guide arrow_forwardMedical Billing Denial Benchmarks 2026: Industry Data, Specialty Breakdowns, Top Denial Codes
Where your denial rate should land in 2026: MGMA/HFMA ranges by specialty, the CARC codes driving denials, and the gap between initial and final denial rates.
Read the Guide arrow_forwardMental 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 Guide arrow_forwardN822 & 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 Guide arrow_forwardNet Collection Rate vs Gross Collection Rate: The Real Difference
Why gross collection rate misleads, why net collection rate is the true performance metric, the formulas, the HFMA target, and how to compute both correctly.
Read the Guide arrow_forwardOrthopedic 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, modifier context, fix and appeal angle.
Read the Guide arrow_forwardPhysical 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 Guide arrow_forwardPR-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 Guide arrow_forwardPR-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 Guide arrow_forwardPR-27 Denial Code: Expenses After Coverage Terminated — How to Fix It
PR-27 means expenses incurred after coverage terminated. The causes, the re-verify-and-rebill fix, PR-27 vs PR-26 vs CO-27, and an appeal template.
Read the Guide arrow_forwardPR-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 Guide arrow_forwardPR-95 Denial Code: Plan Procedures Not Followed — How to Fix It
PR-95 means plan procedures not followed: missing referral, no prior auth, or out-of-network. Learn the fix, retro-auth, and when you can bill the patient.
Read the Guide arrow_forwardUrgent Care Denial Cheat Sheet: Top CARC Denials, Causes, Fixes, and Appeal Angles
The top urgent care billing denials by CARC code — POS 20 vs 11, modifier 25 on procedure-bundled E/M, S-code routing, auth — with the fix and appeal angle for each.
Read the Guide arrow_forwardWhat Is A/R in Medical Billing? Days in A/R, Aging Buckets, and How to Manage Them
A/R in medical billing explained: days-in-A/R calculation, aging buckets (0-30, 31-60, 61-90, 90+), the collection probability curve, and how to keep A/R under.
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