Question 1

What is the difference between medical billing and revenue cycle management?

Accepted Answer

Billing is claim submission and payment posting. Revenue cycle management covers the whole path — eligibility, coding review, claims, denials, AR follow-up, patient balances and reporting.

Question 2

How long does payer credentialing usually take?

Accepted Answer

It varies by payer, state and specialty. Some enrollments move in weeks, others take several months, which is why applications should be submitted as early as possible.

Question 3

What is a healthy AR profile for a small practice?

Accepted Answer

The important signal is trend, not a single number: how much of your AR sits past 90 days, and whether that share is shrinking or growing month over month.

Question 4

Why do clean claims still get denied?

Accepted Answer

Most denials come from eligibility changes, authorization requirements, modifier rules and frequency limits — details that vary by plan rather than by code.

Question 5

Should a small practice keep billing in-house?

Accepted Answer

It works when you have experienced billing staff and real coverage when they're out. It usually breaks down when billing depends on one person, or gets squeezed in between answering phones and checking patients in.

Straight answers about the business side of care.

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