Ask anyone who bills drugs without a dedicated HCPCS code, and they’ll tell you the same story. You submit under an NOC code, you wait, and half the time
Read More
You did the visit. You documented it properly. The care was medically necessary and clinically sound. And Cigna still cuts your payment. That’s the reality practices are waking up
Read More
If your Aetna remittances have looked worse than usual since the start of the year, you’re not imagining it. A coding edit Aetna rolled out in February 2025 has
Read More
If you bill Aetna and you’ve gotten a denial that made no clinical sense, you’re not imagining things. A former Aetna medical director testified under oath that he denied
Read More
You send in a clean claim. Right code, right patient, right provider. Two weeks later the remit lands and one line has been cut with a message like
Read More
You billed the right service. You added the right modifier. The claim still came back denied. If that sounds familiar, the modifier may not be the problem. Its position
Read MoreBCBS Illinois Chiropractic Denials BCBS Illinois Is Denying Chiropractic Claims Over ICD-10 Issues: Are You Affected? You adjusted the patient. You documented the visit. You billed 98940 or 98941
Read More
The #1 trigger for Instant Denials The #1 trigger for Instant Denials is Missing or Inconsistent Diagnosis-to-Procedure Mapping. Meta title: Fix Diagnosis to Procedure Mapping: Stop Instant Denials. Meta
Read More
Duplicate Claim Denials: Why Your Resubmissions Are Being Rejected You fixed the claim. You sent it back. And it came back denied again, this time tagged as a duplicate.
Read More
A2Z Billings Aetna Prior Authorization Denials: What Every Provider Must Know A prior authorization denial from Aetna is not the end of the conversation. It is the start of
Read More