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Each issue goes deep on a single issue — denial patterns, credentialing gaps, coding changes, payer behavior — not a surface-level roundup.

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Written for people who bill and manage practices. Every issue includes something you can implement this week.

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CleanClaimRx · Insider News

Issue Archive

Bi-weekly revenue cycle intelligence for independent practice billers and practice managers. Every issue goes deep on one topic — practical, implementable, and free.

Coming Up
Issue 11 · September 3, 2026 · Coming Soon
PA Denial Appeals: The Step Most Practices Skip Entirely
Prior auth denials feel final. They’re not. Here’s the appeal process, the documentation standard, and why most PA appeals succeed when they’re filed correctly.
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Issue 10 · August 20, 2026 · Coming Soon
Payer Underpayments Are Not Denials. That’s Why You’re Missing Them.
3-7% of total reimbursement is paid below contracted rates in practices that don’t audit payment accuracy. Here’s how to find it and recover it.
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Issue 09 · August 6, 2026 · Coming Soon
Denied Claims Nobody Appealed: The $20K/Month Math Most Practices Ignore
Payers deny claims knowing most won’t be appealed. At a 70% win rate, most practices are leaving $2,500/month on the table. Here’s the appeal workflow that changes the math.
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Recent Issues
Issue 08 · July 23, 2026
How to Read an EOB Like a Payer Auditor
Most billers read EOBs to post payments. Payer auditors read them to find money. 5 things to check on every EOB before you post — starting with CO-45.
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Issue 07 · July 9, 2026
PA Rules Changed. Here’s Your New Workflow.
CMS finalized new PA response timelines — 72 hours urgent, 7 days standard. Payers are now on a clock. Here’s how to update your workflow to use that leverage.
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Issue 06 · June 23, 2026 · Latest
The Timely Filing Clock: What It Is, When It Runs Out, and How to Stop the Bleed
The most common reason a legitimate claim becomes permanently uncollectable isn’t coding error — it ran out of time. Full tactical breakdown: where the exposure hides, and how to stop the bleed before it starts.
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Issue 05 · June 9, 2026
Federal IDR: What’s Actually Changing
Providers win 80% of Federal IDR disputes. Most independent practices aren’t filing. Here’s where the process stands, what the QPA litigation means right now, and your action item this week.
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Issue 04 · May 12, 2026
Today Is the Day
CMS’s updated ABN form (CMS-R-131) became mandatory on May 12, 2026. The old form is now void. Any practice using the previous version cannot bill the patient for non-covered services. Here’s the update, what it means, and what to do right now.
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Past Issues
Issue 03 · April 28, 2026
The Patient Balance Conversation Nobody Has
Point-of-service collection is the highest-yield move in your revenue cycle. Practices with a working POS collection program run 60–80% collection rates on patient responsibility. Most practices are running 34%. Here’s the difference.
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Issue 02 · April 14, 2026
Your Payer Sent You a Letter. You Filed It. That Was Your Consent.
The unilateral amendment clause is in almost every commercial payer contract. Most billing managers have never heard of it. Here’s how it works, what it costs, and how to stop it from happening again.
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Issue 01 · March 31, 2026
Your Billing Software Isn’t Broken. Your Configuration Is.
Three billing software configuration gaps costing independent practices real revenue — denial queues set wrong, write-off thresholds too low, and eligibility verification timing that guarantees surprises at checkout.
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