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MUE Edits Explained: Units, Indicators and Denials
What medically unlikely edits (MUEs) are, how MAI 1, 2 and 3 change your options, and how a physician practice should respond to an MUE denial.
TPE Audit Process: Medicare Providers’ 45 Days to Fix Errors
Learn how Medicare providers handle each TPE audit round, meet MAC deadlines, attend individual education, and use 45 days to correct errors.
Unspecified Code Denials: U.S. Practices Get a Free Audit for 30 Days
See when unspecified codes fit, read ERA/835 denial signals, triage and appeal claims, track coding risk, and request a free 30 day audit for your practice.
Chronic Care Management Documentation: Five Records Medicare Requires
Learn Medicare’s chronic care management documentation rules for eligibility, consent, active care plans, time logs, EHR templates, and audits.
Modifier 26 vs. TC: U.S. Coders’ Checklist Starts With Indicator 1
Learn when U.S. coders should bill modifier 26 or TC, how the CMS PC/TC indicator affects split eligibility, and what to check on claims to prevent denials.
OIG Exclusion Screening for U.S. Practices: Audit Ready in 72 Hours
Learn how U.S. medical practices screen employees and contractors against the LEIE, verify matches, document checks, and prepare for an audit in 72 hours.
Coding Compliance Alerts Help Coders Spot 7 Audit Flags Before October
Build coding compliance alerts around authoritative updates, seven audit flags, and an October readiness checklist to catch claim risks before submission.
AI Coding Audits for Independent Practices: Test a 30 to 90 Day Pilot
Evaluate AI coding audits with a 30 to 90 day prebill pilot, track denial rates and compliance, and compare a self managed approach with HIMShield.
Coding Correction Workflow: 4 Steps Independent Practices Can Defend
Independent physician practices can use a four step coding correction workflow to fix errors, follow payer rules, and keep an audit trail ready for review.