Tag: Revenue Cycle Management

Direct Member Reimbursement form

Direct Member Reimbursement Form: A Complete Guide for Healthcare Providers

In today’s complex healthcare billing environment, patients are increasingly paying out-of-pocket for medical services and later seeking reimbursement from their insurance plans. This shift has made the Direct Member Reimbursement (DMR) form an essential component of the revenue cycle for both patients and healthcare providers. A Direct Member Reimbursement form allows insured members to request […]
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Revenue cycle strategies

From Claims to Collections: Revenue Cycle Strategies Defining 2026

As healthcare organizations step into 2026, the revenue cycle is no longer just a back-office function—it has become a strategic engine that directly impacts financial stability, patient trust, and long-term growth. The journey from claims submission to final collections is being reshaped by rapid regulatory changes, evolving payer expectations, staffing challenges, and rising patient financial […]
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HCPCS Level II D codes

HCPCS Level II D Codes: Complete Guide to Dental & Medical Billing Compliance

The Healthcare Common Procedure Coding System (HCPCS) Level II plays a critical role in reporting supplies, non-physician services, and durable medical equipment not captured by CPT® codes. Among these alphanumeric codes, HCPCS Level II D codes are specifically designed to represent dental procedures and services. While primarily associated with dental billing, D codes are increasingly […]
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RARCs

A Complete Guide to Remittance Advice Remark Codes (RARCs) in Medical Billing

Medical billing is complex since there are a number of codes, rules, and messages that healthcare providers and payers have to follow.   This technique is very crucial to use Remittance Advice Remark Codes (RARCs).   Healthcare workers need to know how to utilize RARCs to bill appropriately, be paid on schedule, and keep track of their […]
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Modifier 81

Modifier 81 Complete Guide: Accurate Usage for Assistant Surgeon Billing

Accurate modifier usage is one of the most important elements in achieving clean claim submissions and full reimbursement in surgical billing. Among the lesser-used but extremely important surgical modifiers is Modifier 81 – Minimum Assistant Surgeon. Many practices overlook or misuse this modifier, leading to preventable denials, delayed payments, and compliance issues. This comprehensive guide […]
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EDI rejections in medical billing

Guide to Preventing and Resolving EDI Rejections in Medical Billing

Electronic Data Interchange (EDI) rejections are one of the biggest obstacles in the medical revenue cycle process. They prevent claims from reaching the payer’s adjudication system, leading to costly rework, delayed reimbursements, and longer accounts receivable (AR) days. This guide explores the most frequent types of EDI rejections, their root causes, how to interpret EDI […]
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Medical claim denial code co15

Understanding Medical Claim Denial Code CO-15: Causes, Fixes, and Prevention

 Key Takeaways Denial Code CO-15 occurs when authorization or referral information is missing, invalid, or mismatched. Common causes include expired authorizations, incorrect provider details, or billing mismatches. Prevent CO-15 denials through automation, staff training, and proactive verification. Collaborating with a trusted RCM partner like Allzone Management Services can streamline your authorization process and reduce denials […]
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CPT ICD Compliance Checklist

Comprehensive CPT/ICD Compliance Checklist for Healthcare Providers

In today’s highly regulated healthcare environment, CPT and ICD code compliance isn’t just about accuracy—it’s about protecting your revenue, safeguarding against penalties, and ensuring smooth reimbursements. Healthcare providers and billing teams face increasing pressure to align with payer rules, CMS guidelines, and continuous code updates. A single coding error can result in denied claims, delayed […]
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HCPCS C Codes

HCPCS Code Categories: C Codes Overview

The Healthcare Common Procedure Coding System (HCPCS) is a standardized coding system used primarily for billing and reporting medical services and supplies in the United States. Within HCPCS, C codes are a specific category of temporary codes used under the Hospital Outpatient Prospective Payment System (OPPS). These codes are issued by the Centers for Medicare […]
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