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Kaiser Eligibility Verification Banner
by Admin0 CommentsMedical Billing

Kaiser Permanente eligibility verification and referral requirements

A patient hands your front desk a Kaiser card. You run it the way you’d run any other, you see the visit, and three weeks later the claim comes

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UnitedHealthcare Denial Management Guide
by Admin0 CommentsMedical Billing

UnitedHealthcare denial management: common reasons and solutions

A claim comes back from UnitedHealthcare with a denial code and a deadline nobody on your team noticed. Multiply that by a few dozen a week and you have

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Medicare Denials_ Don’t Miss Deadlines
by Admin0 CommentsMedical Billing

Medicare’s Timely Filing Denials Are Increasing Don’t Miss Your Deadline

You saw the patient. The note is signed, the codes are right, and the claim went out the door. Then the remittance lands with one line: “Time limit for

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Medicare Advantage Clinical Denials Are Rising
by Admin0 CommentsClaim Denials

Medicare Advantage Plans Are Denying More Claims on Clinical Grounds

Your claim was coded correctly. A physician ordered the service. The patient needed it. And the plan still says no, because a reviewer who never met the patient decided

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Duplicate Charges, Incorrect Coding, and Insufficient Documentation – Cignas Top Denial Reasons
by Admin0 CommentsClaim Denials

Duplicate Charges, Incorrect Coding, and Insufficient Documentation Cigna’s Top Denial Reasons

You did the work. The patient was seen, the note was signed, the claim went out. Then the remittance lands and Cigna pays you nothing. That happens more often

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Medicare Secondary Payer claims
by Admin0 CommentsClaim Denials

Medicare Secondary Payer (MSP) Claims: Why Your Claims Are Being Rejected

You submit a clean claim. Medicare should be the secondary payer, so you build it that way, code it correctly, and send it off. A few days later, it

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bcbs-noc-code-denials-claims-missing-ndc-number
by Admin0 CommentsMedical Billing

BCBS NOC Code Denials: Are Your Claims Missing the NDC Number?

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

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Cignas Excessive Documentation Policy Could Cost You Thousands
by Admin0 CommentsMedical Billing

Cigna’s ‘Excessive Documentation’ Policy Could Cost You Thousands

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

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Aetnas Modifier Denials Are Increasing Are You Affected
by Admin0 CommentsClaim Denials

Aetna’s Modifier Denials Are Increasing Are You Affected?

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

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Aetna Denied Your Claim Without Reviewing Medical Records Heres What to Do
by Admin0 CommentsClaim Denials

Aetna Denied Your Claim Without Reviewing Medical Records? Here’s What to Do

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

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