February 13, 2025

Coding and Avoiding Fraud: The Importance of Understanding CPT Coding in Medical Billing

Medical billing is a complex process that requires a thorough understanding of Current Procedural Terminology (CPT) codes to ensure compliance with federal regulations and ethical billing practices. These codes are not just numerical representations of services—they come with specific definitions that outline the obligations for how services must be executed, including requirements regarding licensed professionals […]

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Accountability in Medical Billing: Who is Responsible When Billing Does Not Reflect Actual Services Rendered?

Detroit, MI – In medical environments, billing accuracy is paramount—not only for ethical and financial reasons but also for legal compliance. When medical billing does not accurately reflect the services provided, responsibility can fall on multiple parties, including medical billers, healthcare providers, and even facility administrators. However, the legal implications can be severe, particularly under

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Common Denial Codes Used by Insurers in the Michigan PIP System

Insurers in the Michigan Personal Injury Protection (PIP) system frequently use specific denial codes to reject or reduce payments for medical services, attendant care, rehabilitation, and other benefits. Below is an overview of commonly used denial codes and their meanings: Understanding these denial codes is crucial for providers and case managers to challenge inappropriate denials,

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