Research | Medical Billing and RCM Guides

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Practical content for practices that want to collect more of what they bill.

October 22, 2026

What documentation proves medical necessity for a non-emergency ambulance transport?

Medical necessity for a non-emergency ambulance transport is proved by a document set, not a single form. This page maps each document, the clock that governs it, and the wording that survives an audit.

Shivam Pujara, Founder

Denial prevention

October 22, 2026

How do I reduce claim denials?

A 7-step process to reduce claim denials, with the math for a 3-provider practice and what our claim audit shows about which denials to fix first.

Shivam Pujara, Founder

Ambulance Medicare billing

October 22, 2026

How do ambulance services bill Medicare?

How ambulance services code, document and submit Medicare claims, with the fee schedule math and the audit errors that cause most denials.

Shivam Pujara, Founder

Behavioral health coding

October 22, 2026

When do you add interactive complexity code 90785?

The four factors that justify CPT 90785, the codes it can and cannot join, what it pays in 2026, and the documentation that survives an audit.

Shivam Pujara, Founder

ABA Billing

October 22, 2026

How do you get a single case agreement for ABA with an out-of-network payer?

A step by step guide to requesting, pricing and billing a single case agreement for ABA services when the payer has no in-network BCBA available.

Shivam Pujara, Founder

Revenue cycle KPIs

October 22, 2026

What is a good net collection rate?

A good net collection rate is 95% or higher, and 97% to 99% is optimal. Here is the formula, a worked example and what keeps most practices below 95%.

Shivam Pujara, Founder

Ambulance billing

October 22, 2026

How does a Physician Certification Statement (PCS) work for repeat transports?

Medicare requires a Physician Certification Statement dated no earlier than 60 days before each repetitive scheduled ambulance transport. This page works the dates, the signers and the prior authorization interaction.

Shivam Pujara, Founder

Oral surgery billing

October 22, 2026

How do you bill medical insurance for oral surgery and wisdom tooth extraction?

How to bill medical insurance for oral surgery and wisdom teeth: when medical covers it, the CDT to CPT crosswalk, anesthesia, Medicare rules and a worked example.

Shivam Pujara, Founder

Medicare Audiology Billing

October 22, 2026

When does an audiologist use the AB modifier for Medicare direct access?

Modifier AB is the only way to bill a Medicare hearing assessment with no physician order, and it works once every 12 months per beneficiary. The full 38 code list, the two effective dates that trip practices up, and what each denial code actually means.

Shivam Pujara, Founder

Dental medical cross-coding

October 22, 2026