Medicaid

Blogs

CARC OA-B11 / RARC N418: What to Do When a Claim Goes to the Wrong Payer

OA-B11/N418: When Claims Go to the Wrong Payer

A guide for billing professionals on the OA-B11/N418 response code combination, what it means when a claim is transferred to a different payer, why routing errors happen and how to correct and prevent them.

Blogs

Claim Response Code A3/106/85: Billing Provider Charge Errors Explained

A3/106/85: Billing Provider Charge Errors

A breakdown of the A3/106/85 response code, why charges get misassigned to the wrong billing provider and how to correct and resubmit claims with the right provider and entity information.

Blogs

Understanding Claim Response Code PR-2 / RARC N782

PR-2 / N782: QMB Coinsurance Explained

A guide for billing professionals on the CARC PR-2 / RARC N782 response code combination, what it means for QMB patients, why it occurs and how to correct coinsurance charges and prevent future violations.

Blogs

How Billable Coverage is Overlooked in 10-30% of Self-Pay Healthcare Accounts

How Billable Coverage is Overlooked in Self-Pay Healthcare Accounts

A look at why 10-30% of self-pay accounts actually have active billable coverage, the common intake gaps that cause this and how automated insurance discovery helps practices recover that revenue.

Blogs

Why One-Time Patient Eligibility Verification Checks No Longer Work for Health Systems

Why One-Time Eligibility Checks Fall Short

A look at why a single eligibility check at registration no longer reflects a patient's coverage at billing, and how pairing verification with insurance discovery closes both resulting revenue gaps.

Blogs

How Insurance Discovery FC Helps Identify Missing Coverage Before Accounts Move Into Self-Pay

Identify Missing Coverage Before Accounts Move Into Self-Pay

A look at how self-pay accounts often hide missed insurance coverage, and how automated insurance discovery helps practices recover lost revenue without changing existing front-desk workflows.

Blogs

Reduce A/R days by Verifying Insurance in Real Time

A look at how outdated insurance data and manual verification slow the revenue cycle, and how real-time eligibility checks help practices reduce A/R days and improve clean claim rates.

Blogs

Prevent Eligibility Errors Before They Become Denials

Prevent Eligibility Errors Before They Become Denials

A breakdown of where insurance verification workflows commonly break down and how standardizing eligibility checks and insurance discovery can prevent costly claim denials.

Blogs

Claim Response Code A3/21/40: What It Means and How to Fix It

Understanding Claim Response Code A3-21-40

Learn what the A3/21/40 response code means, why claims get returned before adjudication and how to correct missing or invalid information for a clean resubmission.