A patient hands over a Molina card. Your front desk scans it, books the procedure, and moves on. Three weeks later, the claim comes back denied. Coverage ended the
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You scheduled the procedure. The patient showed up. The doctor did the work. Then the claim gets denied again because no one got Cigna’s approval ahead of time, or
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Humana may underpay you, deny you, or hold your claim for weeks. Sometimes, all three issues occur for a single patient. In response, most practices make more phone calls,
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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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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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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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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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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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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
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If you bill Cigna for office visits, mark your calendar. Starting October 1, 2025, Cigna is rolling out a new reimbursement rule that lets the payer quietly cut your
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