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Complete 2026 guide to billing for Medicaid hero banner covering federal rules, state programs, MCO contracts, prior authorization under CMS-0057-F, denial codes, and documentation standards.

By Claim Max RCM May 5, 2026 Comments (0)

Billing for Medicaid: The Complete 2026 Provider Guide

The CMS FY2025 PERM report just landed. The Medicaid improper payment rate jumped to 6.12%, representing $37.39 billion in improper payments. That’s up from $31.10 billion in 2024. Real money. Gone. And most of it wasn’t fraud. Billing

Hyperlipidemia ICD-10 coding guide emphasizing E78 specificity for accurate billing and reduced claim denials

By Claim Max RCM April 28, 2026 Comments (0)

Hyperlipidemia ICD-10 Code E78.5: 2026 Coding and Billing Guide for Healthcare Providers

E78.5 is a billable and specific ICD-10-CM code for hyperlipidemia, unspecified, effective for FY2026 and classified under category E78 (Disorders of lipoprotein metabolism and other lipidemias) per the CDC NCHS ICD-10-CM FY2026 release. It is the

Eligibility verification vs prior authorization errors causing claim denials and revenue loss in medical billing

By Claim Max RCM April 2, 2026 Comments (0)

Eligibility Verification & Prior Authorization: Key Differences Every Healthcare Practice Must Know [2026]

A billing coordinator at a busy orthopedic practice picks up the phone and calls the insurance company. “I need to verify the patient’s eligibility for an MRI,” she says. The rep on the other end pauses,

By Claim Max RCM March 9, 2026 Comments (0)

Medical Billing vs. Revenue Cycle Management: The Complete Guide for Healthcare Providers [2026]

In 2025, 41% of healthcare providers report denial rates exceeding 10%, up from just 30% three years ago (Experian Health’s 2025 State of Claims Survey). For the average practice, that translates to tens of thousands in

By Claim Max RCM January 6, 2026 Comments (0)

Welcome to Claimmax RCM: The Revenue Partner Your Practice Actually Needs

The business of medicine has changed. I have spent the last 15 years working in the trenches of medical billing. I remember when a handshake and a paper claim were enough to keep a practice running.

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