Healthcare Revenue Group Blog

M115 Denial Code: Why Credentialed Providers Still Get Denied

TL;DR. The M115 denial code means a payer treats the provider as non-contracted. Often the real...

NCQA Credentialing Standards 2026: What Practices Must Know

TL;DR: The NCQA credentialing standards 2026 surveys enforce apply to files processed on or after ...

Billing Under Another Physician: What Actually Holds Up

Key Finding: Billing under another physician is legal, but only in narrow cases. Reciprocal billing...

Behavioral Health Provider Services: The Complete Guide

TL;DR Behavioral health provider services face real 2026 shifts. NCQA renamed its MBHO...

Medicaid Credentialing: State-by-State Basics

TL;DR Medicaid credentialing is not one process. It is 50-plus separate state programs, each with...

How to Choose a Medical Billing Company: 2026 Vetting Guide

TL;DR: How to choose a medical billing company comes down to four checks: the real cost after every...

Medicare Provider Enrollment: Payer-by-Payer Timelines

TL;DR: Medicare provider enrollment usually runs 45 to 90 days. Medicaid and commercial payers...

Denial Management in Medical Billing: The Complete Playbook

TL;DR: Denial management in medical billing is prevention first, appeals second. Most denials trace...

Orthopedic Insurance Credentialing: The Complete Guide

TL;DR: Orthopedic insurance credentialing enrolls each surgeon with every payer and facility that...

ABA Therapy Insurance Credentialing: The Complete Guide

ABA therapy insurance credentialing is the work of enrolling an applied behavior analysis practice,...