What is the Appeals Process for Denied Medical Claims?

February 1, 2026 / Alex J. Lau /

The appeals process typically has multiple levels. First-level appeals are often informal reviews where you submit additional documentation or clarification to the payer. If denied again, second-level appeals may involve peer-to-peer review with a medical director. Third-level appeals might go to an external review organization. Each level has specific deadlines, usually 30-180 days depending on […]

What Clean Claim Rate Should My Practice Aim For?

November 1, 2025 / Alex J. Lau /

A clean claim rate of 95% or higher is considered excellent in the medical billing industry. Clean claims are those submitted correctly the first time without errors, requiring no additional information or corrections before processing. The industry average is typically between 75-85%, meaning there’s significant room for improvement in many practices. Low clean claim rates […]