1. Timely Filing Requirements
✔ Submit Medicare claims within 12 months of the service date
✔ Check payer-specific deadlines for Medicaid or MACs
✔ Recheck claims before resubmission to avoid rejections
2. Accurate Coding Standards
✔ Use latest CPT, HCPCS, and ICD-10 codes
✔ Confirm codes match documentation and medical necessity
✔ Apply correct modifiers and units for bundled services
3. Claim Form Essentials
✔ Complete all required CMS-1500 or UB-04 fields
✔ Include NPI, Tax ID, and billing provider info
✔ Attach supporting documents for high-cost procedures
4. Clean Claim Submission
✔ Verify insurance eligibility and prior authorizations
✔ Use clearinghouses for batch submissions and edits
✔ Implement real-time claim scrubbing tools
5. Common Challenges & Fixes
| Challenge | Fix |
| Claim rejected for missing info | Double-check forms before submission |
| Wrong code usage | Stay updated with coding guideline revisions |
| Missed deadlines | Set up alerts in billing software |
| Frequent denials | Analyze denial patterns and retrain staff |
