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The billing team's second brain.

Templates, reference data, decision guides, and regulatory updates. Free. Ungated. Powered by live CMS data.

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Billing Manager

First 30 days: build your toolkit and learn the landscape.

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Denial Specialist

Triage, appeal, and recover with templates and decision guides.

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Compliance Officer

Regulatory updates, coverage policies, and compliance checklists.

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5 coverage policies updated recently

Data from CMS.gov · Updated today

TEMPLATES

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CO-197 Appeal Letter

Appeal template for CARC CO-197 (precertification/authorization absent). Includes auth reference documentation and retro-auth language.

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CO-4 Modifier Appeal Letter

Appeal template for CARC CO-4 (modifier mismatch). Walks through correct modifier documentation and supporting clinical rationale.

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CO-16 Missing Info Appeal Letter

Appeal template for CARC CO-16 (missing or invalid information). Covers resubmission with corrected data and supporting attachments.

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Prior Authorization Checklist

Step-by-step checklist covering pre-submission verification, clinical documentation, submission tracking, and follow-up deadlines.

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REFERENCE DATA

Always-current lookup tables.

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NCD Update Tracker

Current National Coverage Determinations with effective dates, revision history, and MAC applicability.

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MAC Contractor Directory

Medicare Administrative Contractor assignments by state and jurisdiction, with contact and claims submission details.

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Payer Appeal Deadlines

Appeal filing windows by major payer. Covers first-level, second-level, and external review deadlines.

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DECISION GUIDES

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Should I Appeal This Denial?

Decision framework for evaluating appeal merit. Covers cost-benefit, deadline windows, documentation strength, and payer-specific win rates.

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Denial Triage: First 48 Hours

Triage protocol for new denials. Prioritize by dollar amount, deadline urgency, and pattern frequency. Route to correct resolution path.

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The billing team's second brain.

I'm a...

Billing Manager

Denial Specialist

Compliance Officer

Copy, fill in the brackets, send.

CO-197 Appeal Letter

CO-4 Modifier Appeal Letter

CO-16 Missing Info Appeal Letter

Prior Authorization Checklist

Always-current lookup tables.

NCD Update Tracker

MAC Contractor Directory

Payer Appeal Deadlines

Follow the path to the right response.

Should I Appeal This Denial?

Denial Triage: First 48 Hours

Role-based learning paths

New Billing Manager: First 4 Weeks

Denial Specialist: First 3 Weeks

Compliance Officer: First 3 Weeks

Ready to go beyond templates?