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Service Denial Management … has time to appeal. Practices with recurring denials for eligibility, authorization, medical necessity or modifiers. Anyone already using Revelrex Medical Billing who wants the … Service Medical Billing … Claim preparation Claims are scrubbed for payer rules, eligibility, authorization and referral requirements, modifiers and place of service before submission. Claim …

Course Medical Billing Everything a professional biller does, practiced end to end: eligibility, charge entry, claim scrubbing and submission, clearinghouse rejections, payment posting, AR follow-up, patient statements and payer communication. Add-on Hands-On RCM Simulation & Practice Lab An add-on to any course. Run a simulated practice for six weeks: register patients, verify eligibility, review encounters, code, build and submit claims, handle rejections and denials, post payments, work AR and solve t… Course RCM Fundamentals The complete map of the revenue cycle, from scheduling and eligibility to payment posting and AR, explained with real examples so every later course makes sense. Course EMR Training Hands-on training in a real EMR workflow: scheduling, registration, eligibility, charting basics, orders, charge capture and the billing hand-off, using synthetic patients only.

Practice Management · Aug 3, 2026 · 8 min What to Include in an Eligibility Verification Workflow for Your Front Desk Eligibility denials are the easiest denials to prevent and among the most common. A workflow that checks the right things at the right three moments, records what was checked, and gives the front desk a script for failu… Industry News · Jul 8, 2025 · 8 min OBBBA Medicaid Changes: What Practice Eligibility Workflows Need Now The One Big Beautiful Bill Act became law on July 4, 2025. Its Medicaid provisions arrive in stages from 2026 to 2028, but the eligibility habits that will protect a practice need to start this year. Here is what change… RCM Operations · Jun 17, 2025 · 8 min Medicaid Eligibility Checks After the Unwinding: What Still Goes Wrong The Medicaid unwinding is over, but the churn it created is not. Over 25 million people were disenrolled, most for paperwork reasons, and many came back under a different managed care plan. Here is how eligibility for M… Compliance · Jul 30, 2025 · 7 min MIPS 2025 Midyear Checkpoint: Eligibility, PI Window and Quality Completeness The 2025 MIPS performance year has a 75-point threshold and a penalty of up to 9 percent on 2027 Medicare payments. Late July is the last realistic moment to fix eligibility, Promoting Interoperability and quality data … Payer Operations · Apr 29, 2026 · 9 min Medicaid Managed Care Billing: Enrollment, Taxonomy Codes and Retro Eligibility … there are two layers of rules. The state sets enrollment, eligibility and some claim requirements; the managed care organization (MCO) sets its own credentialing, authorization, … Practice Management · Apr 16, 2026 · 8 min Medicaid Work Requirements Arrive January 2027: Eligibility Outreach Starts Now … 1, 2027, states that expanded Medicaid must condition eligibility for most adults aged 19 to 64 in the expansion group on 80 hours per month of work, job training, education … Revenue Leakage · Sep 25, 2026 · 9 min Preparing Front-Desk Collections for the January Deductible Reset In January most patients owe the full visit cost until the deductible is met. Practices that collect at the desk in January collect it; practices that send statements in March mostly do not. Here is the fourth-quarter p… Compliance · Sep 15, 2026 · 8 min Medicaid Work Requirements Start January 2027: Preparing Your Front End Under Public Law 119-21 and the CMS interim final rule issued June 1, 2026, states must apply an 80-hour monthly community engagement requirement to Medicaid expansion adults by January 1, 2027. Here is what it changes …