Most medical billing books are either comprehensive textbooks that take weeks to read or exam prep guides that teach you to pass a test rather than do the job. This book is neither. It is organized by the problem you are facing right now. Turn to the chapter that matches your denial. Find the root cause, the fix, the prevention workflow, and the appeal letter. Every chapter is self-contained. Every protocol is immediately usable.
The national average first-pass claim rate is around 85 percent. Practices that implement the prevention workflows in this book consistently achieve first-pass rates of 95 percent or higher. That 10-percentage-point gap is real money — on a practice billing $2 million per year, it represents $200,000 in claims that no longer require rework, follow-up, or appeal.
Who This Book Is For
Medical billers at any experience level. Billing managers building a denial management system. Front desk and registration staff whose errors show up as CO-16 and CO-31 denials. Practice administrators who need to understand what the KPIs mean and what to do when they are wrong. Independent contractors building a remote billing business. Anyone preparing for the CPC, CPB, or CBCS examination who wants to see how the content applies in real denial scenarios.
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