HealthcareCompliance

Medicare Telehealth Policy Changes

Navigate Medicare Telehealth Policy Changes 2025 Cliff

Leave a Comment / November 2025

Healthcare providers, practice managers, and clinic owners face a major shift following the recent Medicare Telehealth Policy Changes 2025. The temporary flexibilities that made virtual care so accessible officially expired on October 1, 2025. Congress took no swift legislative action to extend the waivers. Consequently, the Centers for Medicare & Medicaid Services (CMS) reverted to […]

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N472 Denial Code

N472 Denial Code Prevention: Stop Duplicate Billing Errors

Leave a Comment / August 2025

If you’re a practice manager, healthcare provider, or clinic owner, you know how frustrating claim denials can be—especially the notorious N472 denial code. This code signals that another provider has already received payment for the service. This issue instantly stalls your revenue cycle and creates a cascade of administrative work. While this denial is frustrating,

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Denial Code MA109

Stop Denial Code MA109 ASC Billing Denials Today

Leave a Comment / February 2025

Practice managers, healthcare providers, and practice owners operating Ambulatory Surgery Centers (ASCs) know the constant pressure of maximizing facility revenue. Consequently, Denial Code MA109 ASC Billing is a frequent and costly obstacle. This denial occurs when payers process surgical claims under specific ASC guidelines but identify billing or coding discrepancies. These rejections create unnecessary revenue

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GA modifier

GA Modifier UHC Commercial Claims: 4 Steps to Compliance

Leave a Comment / January 2025

Starting February 1, 2025, a critical update from UnitedHealthcare (UHC) will reshape billing for certain commercial plan claims. Specifically, UHC will require the GA Modifier UHC Commercial Claims. This update is mandatory for services UHC may deem potentially non-covered. Consequently, healthcare providers, practice managers, and practice owners must act now. Missing the modifier or the

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Denial Code 50

Eliminate Denial Code 50 Lack of Medical Necessity Losses

Leave a Comment / January 2025

For practice managers, healthcare providers, and practice owners, few claim rejections are more challenging than those triggered by Denial Code 50 Lack of Medical Necessity. This denial occurs when insurers reject claims. Specifically, they reject the claim because the service lacks sufficient documentation to prove its clinical necessity. Consequently, these denials mean lost revenue, wasted

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Denial Code 198

Stop Denial Code 198 Missing Precertification Denials

Leave a Comment / January 2025

For healthcare providers, practice managers, and practice owners, few claim rejections are as common or as costly as those flagged with Denial Code 198 Missing Precertification. This denial is frustratingly simple: your claim was rejected because it lacked the required precertification, authorization, or notification for a specific service. Precertification, or prior authorization, is a mandatory

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Remark Code MA37

Fix Remark Code MA37 Missing/Invalid Patient Address Denials

Leave a Comment / December 2024

Healthcare providers and practice managers often face claim denials due to Remark Code MA37 Missing/Invalid Patient Address. This common denial stems from incorrect, incomplete, or invalid patient address information. Consequently, these administrative errors lead to significant revenue losses for practices. Therefore, understanding the root causes of Remark Code MA37 Missing/Invalid Patient Address and implementing actionable

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