February 24, 2026

What are CPT Category II Codes? CPT Category II (CPT II) codes are optional tracking codes used to report performance measures, quality of care, and patient outcomes. They complement standard CPT codes (Category I) but do not affect reimbursement directly. Purpose: Monitor healthcare quality and compliance with HEDIS and other performance measures. Example: 3078F reports […]

What is a Clearinghouse in Medical Billing? A medical billing clearinghouse is an intermediary that receives claims from healthcare providers, validates them for errors, formats them for insurance payers, and routes them efficiently. Clearinghouses ensure accurate submissions, faster reimbursements, and reduced claim denials. Key Insight: According to the American Health Information Management Association (AHIMA, 2022),

How to Reduce Denial Rates and Increase Clean Claim Percentages in Your Medical Billing Process You reduce denial rates and increase clean claim percentages by fixing front-end data, verifying coverage, coding with documentation, and running claim edits before submission. A clean claim passes payer edits on the first submission and pays without manual rework. Next,