Compliance
Policies, standards, and audit-ready billing operations.
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Revenue CalculatorEstimate how much revenue your practice may be losing to denials and slow A/R.
Pricing GuideHow percentage, flat monthly and per-service billing plans work.
Practice AuditAn honest outside review of your A/R, denials and coding by our audit team.
HIPAA & ComplianceHow we protect patient data and bill compliantly.
Supported SoftwareThe EHR, practice management and clearinghouse systems we work in.
Specialties & Coverage40+ specialties in all 50 states, with state payer rules.
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Explore compliance guidance, software information, specialty billing support, and medical billing insights from Agile Nexus Solutions.
Free tools
Revenue CalculatorEstimate how much revenue your practice may be losing to denials and slow A/R.Pricing GuideHow percentage, flat monthly and per-service billing plans work.Practice AuditAn honest outside review of your A/R, denials and coding by our audit team.HIPAA & ComplianceHow we protect patient data and bill compliantly.Supported SoftwareThe EHR, practice management and clearinghouse systems we work in.Specialties & Coverage40+ specialties in all 50 states, with state payer rules.Medical billing guides
Dental Billing vs. Medical Billing: What Dental Practices Need to KnowDental and medical billing use different codes, claim forms and plan rules. Learn when to bill dental vs. medical insurance and how to avoid the most common dental claim problems.Read the guide CAQH ProView: How to Set Up and Keep Your Profile CurrentMost commercial payers rely on CAQH ProView for credentialing. Learn what goes into a complete profile, why re-attestation every 120 days matters, and how to avoid delays.Read the guide NCCI Edits in Medical Billing: PTP Edits, MUEs and How to Avoid DenialsNCCI edits stop many claims before a person ever reviews them. Learn how PTP edits and MUEs work, which modifiers are allowed and how to keep your claims clean.Read the guide Claim Denial Management: Why Claims Get Denied and How to Get PaidDenied claims are revenue waiting to be collected. Here are the most common denial reasons, how to read denial codes and a simple process to prevent and appeal denials.Read the guide Provider Credentialing and Payer Enrollment: A Step-by-Step GuideA provider cannot be paid until credentialing and enrollment are complete. Learn the steps, the documents you need, typical timelines and how to avoid costly delays.Read the guide 7 Revenue Cycle KPIs Every Medical Practice Should TrackYou cannot improve what you do not measure. These seven revenue cycle KPIs show how healthy your billing is and where money is being lost.Read the guide Insurance Eligibility Verification: The First Step to Clean ClaimsEligibility problems are one of the top causes of claim denials. Learn what to verify before each visit and how a simple routine prevents surprise bills.Read the guide Prior Authorization: How to Reduce Delays and DenialsPrior authorization delays care and causes denials when it is missed. Here is how to build a reliable authorization process and what is changing in the rules.Read the guide
Medical billing basics for practice owners
Every insurance payment starts long before a claim is sent. Getting paid quickly depends on a few simple habits: checking each patient's coverage before the visit, getting prior authorizations in time, coding from complete notes, and sending clean claims within each payer's filing limit.
After the claim goes out, the work continues. Payments must be posted line by line, underpayments compared with your contracts, and every denial corrected or appealed before its deadline. Claims that sit in A/R for more than 90 days become much harder to collect, so a steady follow-up routine matters more than any single fix.
Finally, measure what happens. Track your net collection rate, days in A/R, first-pass claim rate and denial rate every month. When a number moves the wrong way, look for the step that caused it: front desk, coding or follow-up.
- How to verify insurance eligibility
- Why claims get denied and how to fix them
- The 7 revenue cycle KPIs to track
- Credentialing and payer enrollment, step by step
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