Denial Claims

CPT 70551 reports magnetic resonance imaging (MRI) of the brain, including the brain stem, performed without contrast material. While identifying the code may appear straightforward, accurate reimbursement depends on more than selecting 70551. The physician order, authorized procedure, performed imaging protocol, diagnosis, documentation, billing component, and submitted claim should all align. A claim can still […]

Cardiovascular stress testing helps clinicians evaluate how the heart responds to exercise or pharmacologic stress and can support the assessment of coronary artery disease, exercise tolerance, ischemia, and other cardiac conditions. From a billing perspective, however, a stress test is not always a single service. Supervision, ECG tracing, technical performance, interpretation, stress echocardiography, and nuclear […]

Claim denials affect hospitals of every size, but their financial impact is rarely equal. Small hospitals operate with tighter margins, leaner revenue cycle teams, and fewer revenue buffers. When claims are denied, reimbursement delays can quickly influence cash flow and operational stability. Industry estimates show that 8–10% of hospital claims are initially denied, and nearly […]

CO 96 is one of the most frequently reported denial codes in medical billing. It indicates that the service billed is not covered under the patient’s current benefit plan. Although the definition appears straightforward, CO 96 denials often expose deeper revenue cycle weaknesses, particularly in eligibility verification, benefit interpretation, and authorization workflows. Left unmanaged, repeated […]

A/R days rising above 50 rarely happen by accident. They build up slowly through repeated errors that interrupt the claims cycle long before a denial appears. Industry data shows 65–72% of denials are preventable, yet many organizations continue to lose cash flow to issues that could have been corrected upstream. When demographic accuracy, eligibility checks, […]

Whether you’re managing a practice, overseeing Billing operations, or driving revenue strategy, one thing is clear: claims management is the financial core of healthcare finance. It’s the bridge between the care you deliver and the payments that keep your doors open. Get it right, and your finances are stable. Mess it up, and you’re constantly […]