Otter Health Raises $8M to Replace Some Prior Auth With AI Care Checks. What Billers Should Ask
On October 15, 2026, Otter Health launched with $8 million in seed funding co-led by Fika Ventures and Evidenced. The startup sells…
Medical Billing 101 – Free Denial Code, CPT & RCM Guides
Most Used RCM & Denial Resolution Guides
- Appeal Letter Generator Build an editable payer appeal letter from the denial code, claim details and the arguments that fit.
- Timely Filing & Appeal Deadline Calculator Work out the claim, corrected claim or appeal deadline and how many days you have left.
- Denial Code Lookup (CARC & RARC) Find what a denial code means in plain English and the steps to fix it.
- CO-97 Bundling Denials: NCCI Edits and Modifiers Check the NCCI edit, decide whether modifier 59 or an X modifier applies, and correct or appeal.
- CO-16 Missing Information Denials Read the remark code, fix the missing or invalid claim data and resubmit.
- CO-29 Timely Filing Denials Prove the claim went out on time, or find the exception that lets you appeal.
- CO-50 Medical Necessity Denials Match the diagnosis to the coverage policy and build the records for an appeal.
- ER Visit Denied as Not an Emergency Use the prudent layperson rule to appeal an emergency room denial.
- About the Author: Manikandan J, CPC, CRCR Who writes and fact-checks these guides, with 10+ years in US revenue cycle management.
Free Billing Tools
Quick, free helpers for billers, coders and patients. No sign-up.
Appeal Letter Generator
Pick a denial code and payer, fill in claim details, copy a ready-to-edit appeal letter.
Timely Filing Deadline Calculator
Enter the date of service or EOB date to see claim and appeal deadlines.
Denial Code Lookup
Search any CARC/RARC (e.g. CO-97, CO-16) for its meaning and fix steps.
PHTI Report: AI Billing Tools Are Raising Health Costs. What Coders and Billers Should Do Now
On October 14, 2026, the Peterson Health Technology Institute (PHTI) released a report called Driving Adoption of High-Value AI in Healthcare. Its…
UnitedHealth Says AI Cut Appeal Cycle Times 26%. What Billers Should Watch on Claims and Coding
On October 13, 2026, UnitedHealth Group used its third-quarter earnings call to put numbers on its AI push. CEO Steve Hemsley said…
CMS-0057 Electronic Prior Auth Hits Jan. 1, 2027. What Billers Must Ask EHR and AI Vendors Now
On October 12, 2026, Medical Economics published a practice-facing checklist for the January 1, 2027 Prior Authorization API deadline under CMS-0057-F —…
Suki Raises $90M to Build AI Agents for Prior Auth and Referrals. What Billers Should Demand
On October 13, 2026, ambient clinical intelligence company Suki announced $90 million in Series E financing. New investors include Healthier Capital, Crosslink…
Florida Medicaid VFC Vaccine Denials (CARC 16, M51, N111): Bill Two Lines per Vaccine
Florida Medicaid wants two codes for every vaccine you give. One is the vaccine product code. The other is the administration code,…
Hospitals Push Back on BCBSA’s $942M AI Coding Claim. What Coders Should Do Next
The American Hospital Association is pushing back on a Blue Cross Blue Shield Association claim. BCBSA says AI-assisted hospital coding added about…
WISeR Brings AI Prior Auth to Original Medicare. What Senators’ Oct. 9 Roundtable Means for Billers
On October 9, 2026, Sens. Patty Murray (D-WA) and Ron Wyden (D-OR) held a Vancouver roundtable with Washington clinicians about CMS’s Wasteful…
Fitch: Human Review of AI Prior-Auth Denials Is Likely to Stay. What That Means for Billers
Fitch Ratings’ Artificial Intelligence Stress Test, published October 5, 2026, scores health insurers at 20 out of 100. That is well below…
Humana and UnitedHealth AI-Denial Lawsuits Reach Class-Certification Deadlines: What Medicare Advantage Patients Should Know
Two class actions make the same claim. They say Medicare Advantage insurers used an AI tool called nH Predict to end nursing…