A2zbillings

Ohio Behavioral Health Credentialing: ODM Enrollment, OhioRISE and OhioMHAS Rules Explained

A claim for a 45-minute therapy session gets denied in Ohio, and the reason has nothing to do with the clinical note. The provider enrolled under a category that does not match the service. Or a child on OhioRISE was seen by a therapist who

AI in eligibility verification: what it fixes, what it still misses

A patient returns for a follow-up visit with the same insurance card as last time, and the front desk checks them in. Three weeks later the claim comes back with denial code CO-27, coverage terminated. The patient changed jobs a month earli

Michigan BCBA credentialing guide: LARA, CHAMPS, PIHPs, and commercial payers (2026)

A Michigan BCBA can hold valid BACB certification and still be unable to bill a single claim. The state treats certification and licensure as separate credentials, and every payer then runs its own enrollment on top of both. A missed step e

Michigan No-Fault Billing for Providers: Fee Schedule, Reductions, and Getting Paid

A therapy clinic in Lansing sees a crash patient for an hour. It bills the auto insurer four units. The check that comes back is about a third lighter than anyone expected. The EOB lists a "fee schedule" adjustment and two reduction codes.