Timely filing limits differ by payer, by program and by contract. This reference gives the published window for Medicare, Medicaid, TRICARE and the major commercial payers, the rule behind each number, and the codes a late claim comes back with.
Definitions of the 70 terms that come up most in US medical billing, from the CARC on an 835 remittance to days in A/R, each checked against CMS, X12 and the Code of Federal Regulations.
The headline conversion factor rose in 2026. Underneath it, a work RVU efficiency adjustment cut thousands of non-time-based codes and a rebuilt practice expense method moved money between hospital and office settings. Your code mix decides whether you gained.
A healthy practice runs 30 to 40 days in A/R, and most are standing still. Here is where the benchmarks come from, what the aging buckets behind the number reveal, and how to pull a slow cycle back down.
The federal dispute process for out-of-network claims was rewritten in 2026: the fee dropped from $115 to $15 per party, batching was rebuilt, and payers now have to say more on the remittance. Here is what changes in practice.
Denial rates dipped in 2026 while payer takebacks rose. Here is what the CARC codes on your remittance actually mean, which ones you can still fix, and the 30-day workflow that keeps them from coming back.
