Healthcare Providers’ Complete Guide to the CO-97 Denial Code: What Causes It, How to Fix It, and How to Avoid It
What does the CO-97 Denial Code mean? The CO-97 denial code is a common problem that healthcare providers have when they bill patients. This code shows up when a service or procedure is incorrectly billed separately instead of being bundled with another. This leads to a denial. We at Pro-Medsole RCM know how much CO-97 […]
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The 8-Minute Rule in Therapy Billing: A Simple Guide for Smarter Reimbursements
One of the most significant, yet confusing, Medicare billing concepts in therapy is known as the 8-Minute Rule. It shows you the way outpatient therapists charge via time-based CPT codes under Medicare Part B. This is a rule for all types of therapists, including physical therapists, occupational therapists, and speech-language pathologists who work as suppliers […]
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Modifier 95 in Medical Billing: How to Bill Telehealth Services Correctly in 2025
Introduction With telehealth revolutionizing healthcare in the modern age, proper billing and coding are of utmost importance. Modifier 95 in medical billing is critical for ensuring providers are reimbursed appropriately for telehealth services delivered through audio-video communication. This guide explains what CPT Modifier 95 is, when and how it should be used, how it differs […]
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Understanding POS 11 in Medical Billing: A Complete Guide
Understanding POS 11 in Medical Billing: A Complete Guide Introduction Medical billing is totally about codes that tells what service was provided, who provided it, and where it was performed. One of the most frequently used and mostly misunderstood codes is POS 11 in medical billing. This simple two-digit code has a direct impact on […]
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Coding Compliance in Medical Billing – A Complete Guide by Pro-MedSole RCM
Coding Compliance in Medical Billing – A Complete Guide by Pro-MedSole RCM The healthcare industry depends on accurate documentation and medical billing practices. Coding compliance plays an important role for claims to billed correctly; the healthcare providers follow CMS coding guidelines. For healthcare organizations, to stay compliant with coding standards is not only a legal […]
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Provider Enrollment and Credentialing – A Complete Guide by Pro-MedSole RCM
Provider Enrollment and Credentialing – A Complete Guide by Pro-MedSole RCM Introduction Healthcare organizations depend on accurate billing and timely reimbursements to stay financially strong. Before submitting a claim of healthcare providers, there is a process of provider enrollment and credentialing. This process verifies qualifications, establishes the contracts with insurances, and offer compliance with healthcare […]
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Physical Therapy CPT Codes – Complete Billing Guide for Therapists
Physical Therapy CPT Codes – Complete Billing Guide for Therapists Introduction Medical Billing in physical therapy is not only about entering numbers, it requires accuracy, consistency, and detailed knowledge of physical therapy CPT codes. A single error may result in claim denials and delayed reimbursements. At Pro-MedSole RCM, we work with physical therapy providers to […]
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