Knowledge Base & FAQ

Every Question About
Medical Billing— Answered.

From denial management to credentialing, prior authorization to RCM software — clear, expert answers to the questions practices ask most.

Denial Management

Eligibility

Prior Auth

Credentialing

Radiology Billing

Billing Companies

Clear Filter

98.5%

Clean Claim Rate — industry avg 85%

1.5%

Avg Denial Rate — industry avg 11.8%

<20

A/R Days — industry avg 42 days

87%

Denials caught by MAXIMUS AI pre-submission
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Foundations

Revenue Cycle Management & Medical Billing Basic

What is the difference between medical billing and revenue cycle management (RCM)?

Medical billing is the process of submitting claims to insurance payers and collecting payment for healthcare services. It covers tasks like coding diagnoses and procedures, submitting claims, and following up on unpaid balances.

Revenue cycle management (RCM) is the broader, end-to-end financial process that starts before a patient even walks in the door — encompassing scheduling, insurance eligibility verification, prior authorization, claim submission, denial management, patient collections, and financial reporting. Medical billing is a critical component within RCM, but RCM also includes front-end denial prevention, analytics, and compliance oversight.

In short: billing is a subset of RCM. MedCods manages your entire revenue cycle, not just claims submission.

A clean claim is one that is submitted correctly the first time — with accurate patient demographics, valid insurance information, correct procedure (CPT) and diagnosis (ICD-10) codes, appropriate modifiers, and no missing required fields. It passes all payer edits without triggering a rejection or request for additional information.

Clean claim rate matters enormously because rejected or corrected claims delay payment and cost staff time to rework. The industry average clean claim rate hovers around 85%, meaning roughly 1 in 7 claims needs rework before payment. MedCods achieves a 98.5% clean claim rate through AI-powered pre-submission scrubbing, reducing your administrative burden and accelerating cash flow.

CPT codes (Current Procedural Terminology) are five-digit codes that describe the procedures and services a provider performs — such as an office visit, surgery, or imaging study. They are maintained by the AMA.

ICD-10 codes (International Classification of Diseases, 10th Revision) describe the patient’s diagnosis or condition. Every CPT code submitted must be supported by a medically appropriate ICD-10 code, or the claim will be denied for medical necessity.

HCPCS codes (Healthcare Common Procedure Coding System) cover services, supplies, drugs, and equipment not captured by CPT — like durable medical equipment, ambulance services, and injectable medications. Level I HCPCS = CPT codes; Level II are the alphanumeric codes like J0130.

Errors in any of these — wrong code, outdated code, mismatched diagnosis-to-procedure pairing, or missing modifiers — are leading causes of claim denials. MedCods’ MAXIMUS AI engine catches coding errors before submission.

A/R days (Accounts Receivable days, or Days in A/R) measures how long it takes on average to collect payment after a service is rendered. It is calculated by dividing total outstanding A/R by average daily charges.

The industry average is approximately 42 A/R days. A well-performing practice should aim for fewer than 30 days. MedCods clients average fewer than 20 A/R days — more than 50% faster than the industry norm — due to faster claim submission, proactive denial management, and automated patient balance follow-up.

High A/R days signal cash flow problems, billing inefficiencies, or denial backlogs that are silently eroding your practice’s revenue.

MAXIMUS is MedCods’ proprietary AI coding and pre-submission audit engine. It reviews every claim before it leaves your system, performing hundreds of automated checks including:

  • Code-to-diagnosis pairing for medical necessity
  • Modifier validation and unbundling detection
  • Payer-specific rule application (different payers have different editing logic)
  • Duplicate claim detection
  • Eligibility and authorization cross-referencing

MAXIMUS currently catches 87% of potential denials before submission, converting claims that would have been denied into clean claims that pay on the first pass. The engine continuously learns from denial patterns across MedCods’ client base, improving its accuracy over time without any manual input from your staff.

MIPS (Merit-based Incentive Payment System) is CMS’s value-based payment program for eligible clinicians. Providers submit data across four performance categories — Quality, Promoting Interoperability, Improvement Activities, and Cost — which determine upward or downward adjustments to their Medicare reimbursement (up to ±9% in recent years).

Yes, MedCods supports MIPS reporting. We track your performance throughout the year, identify your optimal measure selections, and submit your data to CMS to maximize your composite score and avoid negative payment adjustments. Our team monitors regulatory updates to ensure your reporting stays compliant as CMS modifies program requirements annually.

Most practices are fully operational with MedCods within 2–4 weeks. The onboarding process includes:

  • EHR/PM system integration and data migration
  • Payer enrollment and credentialing review
  • Staff training on the MedCods portal
  • Workflow configuration specific to your specialty
  • A parallel-run period where we verify accuracy before going live

Complex multi-provider or multi-specialty groups may take slightly longer. We assign a dedicated onboarding specialist to your account to ensure a smooth transition with zero claim submission gaps

MedCods integrates with all major EHR and practice management systems including Epic, athenahealth, Kareo, eClinicalWorks, DrChrono, Modernizing Medicine, NextGen, Allscripts, AdvancedMD, and many others via HL7 and FHIR-based APIs. We also support direct integration through clearinghouse connections.

If your EHR is not on the standard list, our integrations team can build a custom connection. We do not require you to switch EHR systems to work with MedCods.

Denial Management

Claim Denials, Appeals & Denial Management Software

What is denial management in medical billing?

Denial management is the systematic process of identifying, analyzing, appealing, and preventing claim denials from insurance payers. Effective denial management has two equally important components:

  • Reactive: When a claim is denied, billing staff investigate the denial reason, correct any errors, and file an appeal to recover the revenue.
  • Proactive: Tracking denial patterns to fix root causes upstream — so the same denials stop recurring.

Without a structured denial management process, practices typically write off 5–15% of revenue that was rightfully owed. MedCods’ denial management team, combined with MAXIMUS AI, handles both sides — appeals and root-cause prevention.

These terms are often confused but have important distinctions:

Rejection occurs before the claim is processed. The payer or clearinghouse returns the claim because it failed technical edits — missing required fields, invalid member ID, invalid NPI, etc. Rejections are not adjudicated; they simply bounce back and must be corrected and resubmitted.

Denial occurs after the claim is processed. The payer adjudicates it and decides not to pay — for reasons like lack of medical necessity, no prior authorization, patient ineligibility on the date of service, or bundling rules. Denials require a formal appeal process and are tracked differently in the revenue cycle.

Both require action, but denials carry appeal rights and deadlines that vary by payer.

The industry average denial rate is approximately 11.8% of claims submitted. For many independent practices without robust billing support, it can exceed 15–20%. MedCods clients average a 1.5% denial rate — roughly 87% lower than the national average.

We achieve this through a layered strategy:

  • MAXIMUS AI pre-submission auditing catches errors before the claim leaves
  • Real-time eligibility verification eliminates coverage-related denials
  • Payer-specific rule libraries that update automatically as payers change their editing criteria
  • Prior authorization tracking to prevent CO-197 denials
  • Denial heatmaps that identify systemic patterns and trigger upstream workflow corrections

The most frequently encountered denial codes and how MedCods addresses them:

  • CO-4 (Modifier issue): MAXIMUS validates modifier requirements by payer and CPT combination pre-submission.
  • CO-11 (Medical necessity): AI-assisted ICD-10 matching ensures diagnosis codes support the procedure before billing.
  • CO-16 (Missing information): Claim scrubbing catches incomplete fields before submission.
  • CO-50 (Non-covered service): Our payer-specific rule libraries flag non-covered services by plan before billing.
  • CO-97 (Bundling): Unbundling logic in MAXIMUS prevents improper code combinations.
  • CO-197 (Missing prior auth): Authorization tracking tools flag missing PAs before the appointment.
  • PR-1 (Patient deductible): Surfaced in pre-visit eligibility checks so patients are informed upfront.

When a claim is denied, MedCods follows a structured appeals workflow:

  • Review: We analyze the Explanation of Benefits (EOB) or Electronic Remittance Advice (ERA/835) to determine the exact denial reason.
  • Classify: Is it correctable (wrong code, missing info) or a true medical necessity dispute requiring clinical documentation?
  • Correct & resubmit: For technical denials, we correct the error and resubmit within the payer’s timely filing window.
  • Formal appeal: For medical necessity or authorization denials, we draft a formal appeal letter supported by clinical documentation pulled from your EHR.
  • Track: Every appeal is tracked to resolution, with escalation to peer-to-peer review or external appeal when appropriate.

Payers have strict appeal deadlines (typically 90–180 days from the denial date). Missing those windows means the revenue is forfeited — which is why prompt action is critical.

Denial heatmaps are visual analytics dashboards in the MedCods platform that map denial patterns across dimensions like payer, provider, CPT code, facility, and denial reason code. They make it immediately visible where denials are concentrating — for example, if 40% of your denials are CO-11 (medical necessity) from a single payer for a specific procedure code.

Rather than treating each denial as an isolated incident, heatmaps reveal the systemic root cause. Once identified, MedCods works with your clinical team to adjust documentation templates, payer-specific coding practices, or prior authorization workflows — so the denial stops recurring rather than being individually appealed indefinitely.

Most practices see measurable improvement within the first 30–60 days. The MAXIMUS AI engine begins pre-submission auditing immediately upon go-live, which reduces new denials from day one. Historic denial backlogs from your previous system are worked through by our appeals team simultaneously.

Within 90 days, the majority of clients reach a denial rate below 3%. Full optimization to our benchmark of 1.5% typically occurs within 3–6 months as MAXIMUS learns your specific payer mix and the heatmap-driven workflow improvements take hold upstream.

An ERA (Electronic Remittance Advice), also called an 835 transaction file, is the electronic document payers send to explain how they adjudicated each claim — what they paid, what they denied, and the reason codes for each action. It is the electronic equivalent of a paper EOB (Explanation of Benefits).

MedCods ingests ERA/835 files automatically as they arrive from payers and clearinghouses. Our system parses the reason codes, maps them to our denial taxonomy, and routes each denied claim into the appropriate appeals workflow — without manual staff intervention for classification. This ensures no denial falls through the cracks and all appeal deadlines are tracked automatically.

Front-End Denial Prevention

Insurance Eligibility Verification & Prior Authorization

What is insurance eligibility verification and why does it matter for billing?

Insurance eligibility verification is the process of confirming — before a service is provided — that a patient’s insurance is active, that your practice is in-network with their plan, and what the patient’s specific benefits are (deductible, copay, coinsurance, coverage limits). It also checks whether a referral or prior authorization is required.

It matters because eligibility-related denials are among the most preventable in billing. If a patient’s coverage has lapsed, their plan changed, or they’re seeing an out-of-network provider without knowing it, the claim will deny and the practice must either pursue the patient directly or write off the balance. Systematic eligibility checks before every visit eliminate this category of denial entirely.

Best practice is to check eligibility at both points — and ideally again 24–48 hours before the appointment.

  • At scheduling: Confirm basic coverage to avoid scheduling patients with lapsed or incompatible insurance.
  • 24–48 hours before the visit: Insurance can change — terminations, plan changes, and employer open enrollment all happen mid-month. A check close to the appointment catches these changes.
  • At check-in: A final real-time check before the encounter confirms nothing has changed since the prior verification.

MedCods automates all three checkpoints via real-time 270/271 eligibility transactions, alerting your front desk to coverage issues before the patient is seen rather than after the claim is denied.

Prior authorization (PA) is a requirement by insurance payers that certain services, procedures, or medications be approved before they are provided. The payer reviews clinical information to determine if the service is medically necessary before agreeing to cover it.

Services commonly requiring prior authorization include:

  • Advanced imaging: MRI, CT, PET scans
  • Elective surgical procedures
  • Specialty medications and biologics
  • Inpatient admissions and skilled nursing facility stays
  • Physical, occupational, and speech therapy (beyond a set number of visits)
  • Durable medical equipment
  • Behavioral health services with certain payers

Requirements vary significantly by payer and plan. Providing a service without an obtained PA results in a CO-197 denial, which is one of the most expensive types of denial to resolve — and sometimes unappealable.

Traditional prior authorization relies on fax, phone calls, or payer web portals — a manual, time-consuming process where staff often wait days for a response, and authorization numbers must be manually entered into billing systems.

FHIR-based prior authorization uses the HL7 FHIR (Fast Healthcare Interoperability Resources) standard to exchange PA requests and responses electronically, in real time, between provider systems and payer systems. Instead of faxing clinical notes and waiting for a callback, FHIR-PA sends a structured electronic request that payers can process and respond to automatically — sometimes in minutes.

MedCods supports FHIR-based PA workflows where payers have implemented the standard, dramatically reducing PA turnaround times and eliminating manual tracking.

CMS-0057-F is a final rule issued by the Centers for Medicare & Medicaid Services that requires payers — including Medicare Advantage plans, Medicaid managed care plans, and CHIP plans — to implement FHIR-based APIs for prior authorization and patient data sharing. Key provisions that took effect January 1, 2026 include:

  • Payers must respond to urgent PA requests within 72 hours and routine requests within 7 calendar days
  • Payers must provide specific denial reasons for PA decisions
  • Payers must implement FHIR PA APIs to allow electronic PA submission from provider systems
  • Payers must publicly report PA metrics annually

For practices, this means faster PA decisions and more transparency. MedCods is fully aligned with CMS-0057-F requirements and supports electronic PA submission to compliant payers.

270 and 271 are HIPAA-mandated electronic data interchange (EDI) transaction sets used for insurance eligibility verification.

  • 270 (Eligibility Inquiry): The request sent from a provider or billing system to a payer asking whether a specific patient has active coverage on a given date.
  • 271 (Eligibility Response): The payer’s reply, containing benefit details including coverage status, deductible amounts, copay/coinsurance information, plan limitations, and whether a referral or PA is required.

MedCods automates 270/271 transactions for every patient on your schedule, returning structured eligibility data that populates directly into your workflow — no manual data entry, no portal logins, no phone calls to insurance companies.

CO-197 denials occur when a service is provided without the required prior authorization on file. MedCods prevents them through a multi-layer authorization management workflow:

  • At eligibility verification, we flag services scheduled for the patient that require PA based on their specific plan rules
  • Automated PA requests are initiated at the scheduling stage — not the day before
  • Authorization tracking dashboards monitor every open PA request, its status, and expiration dates
  • Claims are held from submission until a valid authorization number is confirmed
  • Authorization numbers are automatically attached to claims at billing

This proactive approach has virtually eliminated CO-197 denials for MedCods clients with high PA-volume specialties like radiology, orthopedics, and oncology.

Provider Enrollment

Medical Credentialing & Payer Enrollment Services

What is medical credentialing and why is it required before billing?

Medical credentialing is the process by which insurance payers verify a provider’s qualifications — including their education, training, licensure, board certifications, malpractice history, and work history — before agreeing to reimburse them for services provided to their members.

Until a provider is credentialed and enrolled with a payer, claims submitted under that provider’s NPI to that payer will be denied outright. Credentialing is not optional — it is the gatekeeping process that determines whether a payer will pay your claims at all. New providers, providers joining new practices, and practices adding new payer contracts all require credentialing before billing can begin.

CAQH (Council for Affordable Quality Healthcare) ProView is a centralized database where providers submit and maintain their credentialing information — licenses, certifications, malpractice coverage, education, etc. Most commercial payers and many government payers pull provider data directly from CAQH during the credentialing process, rather than requiring providers to submit the same information repeatedly to each payer individually.

Keeping your CAQH profile complete, accurate, and attested (re-authorized every 120 days) is critical. An outdated or incomplete CAQH profile is one of the most common reasons credentialing applications are delayed. MedCods manages CAQH profile maintenance as part of our credentialing service, so your profile is always current and ready for any new payer enrollment.

PECOS (Provider Enrollment, Chain, and Ownership System) is the CMS online enrollment system for Medicare. Providers and organizations must enroll in PECOS to bill Medicare and Medicare Advantage plans. PECOS enrollment establishes your Medicare billing privileges, associates your NPI with your practice location, and designates your payment routing.

Commercial payer credentialing (Blue Cross, Aetna, United, etc.) is a separate process managed by each private insurer. While CAQH provides a common data source, each commercial payer has its own application, timeline, and review process — and being enrolled in Medicare does not automatically enroll you with any commercial plan. MedCods manages both PECOS and commercial credentialing, tracking each application independently through to approval.

Commercial payer credentialing typically takes 60–120 days industry-wide, depending on the payer. Medicare enrollment via PECOS typically runs 30–60 days but can extend further during high-volume periods or if supplemental documentation is requested.

MedCods accelerates this timeline through proactive application management — submitting complete applications the first time, following up with payer credentialing departments on a structured schedule, and maintaining pre-populated application templates for each major payer. Most of our clients complete the credentialing process 30–40% faster than the industry average because we eliminate delays caused by missing documentation and missed follow-up.

Re-credentialing is the periodic renewal of a provider’s credentials with each payer — typically every 2–3 years. Payers use re-credentialing to confirm that the provider’s licenses are still active, malpractice coverage is current, and no new adverse actions have occurred.

If a practice misses a re-credentialing deadline, the payer can terminate the provider’s participation, which means claims submitted after the termination date will be denied — and the provider may need to go through a full re-enrollment process to be reinstated. Retroactive credentialing is rarely granted, so missed windows can result in permanent revenue loss for services provided during the lapse period.

MedCods tracks all re-credentialing expiration dates and initiates the renewal process 90–120 days in advance, ensuring no lapses occur.

In some cases, yes. When services were provided during a credentialing lapse, recovery options depend on the payer, the nature of the lapse, and how quickly the issue is identified. MedCods will:

  • Audit the lapse period to identify all affected claims
  • Contact the payer to determine if retroactive billing or gap exceptions are available
  • Submit corrected claims or retroactive enrollment requests where payer policy allows
  • Appeal denials that occurred during the lapse period with supporting documentation of the enrollment timeline

While full recovery is not always possible, proactive engagement often recovers a meaningful portion of lost revenue. More importantly, MedCods’ ongoing credentialing monitoring prevents these lapses from occurring in the first place.

Telehealth practices face a uniquely complex credentialing challenge: the provider must typically be licensed in the state where the patient is located at the time of service, and credentialed with payers in each of those states. For practices serving patients across multiple states, this can mean dozens of simultaneous licensure and payer enrollment processes.

MedCods manages multi-state credentialing through a centralized tracking system that maps each provider’s active licenses, pending applications, and payer enrollment status by state. We use interstate compacts (like the Interstate Medical Licensure Compact for physicians) where available to streamline licensure, and manage each state’s commercial payer applications in parallel. Practices receive a real-time dashboard showing exactly where they can bill and where enrollment is still pending.

Yes, behavioral health credentialing has several unique characteristics:

  • Payers often require additional documentation specific to mental health licensure — LCSW, LPC, MFT, psychologist, psychiatrist each have different licensing boards and requirements
  • Many behavioral health payers have enrollment freezes or closed panels, particularly for certain provider types in high-demand markets
  • TRICARE and VA Community Care credentialing for behavioral health has distinct requirements
  • Parity law compliance documentation may be required
  • Supervision requirements for associate-level clinicians must be clearly documented

MedCods has dedicated credentialing specialists experienced in behavioral health payer enrollment who understand these nuances and manage the process accordingly.

Specialty Billing

Radiology Billing Software & Imaging RCM

What makes radiology billing different from other medical specialties?

Radiology billing is among the most technically complex specialties in medical billing for several reasons:

  • TC/26 splitting: Radiology services are often billed as separate technical component (TC) and professional component (26) claims to different payers
  • High PA volume: CT, MRI, PET, nuclear medicine, and many interventional procedures require prior authorization through Radiology Benefit Managers (RBMs)
  • High CPT code volume: Radiology spans thousands of CPT codes across diagnostic, interventional, nuclear medicine, and ultrasound categories
  • Multi-site complexity: Radiologists often read for multiple hospital systems and imaging centers simultaneously
  • RBM requirements: Payers contract with RBMs (like Evolent, AIM) who have their own authorization portals and criteria separate from the payer’s

Billing errors in radiology are expensive — a single missed modifier or incorrect TC/26 split can result in denial of high-value imaging claims.

Many radiology CPT codes represent both a technical component (TC) — the equipment, supplies, and technologist performing the study — and a professional component (26) — the radiologist’s interpretation and report.

  • Modifier TC is appended when billing only for the equipment and technical performance of the study (typically billed by the facility or imaging center)
  • Modifier 26 is appended when billing only for the physician interpretation (billed by the radiology group or independent radiologist)
  • Global billing (no modifier) is used when the same entity owns both the equipment and employs the interpreting physician

Incorrect TC/26 application leads to duplicate billing denials or underpayment. MedCods applies the correct modifier configuration based on the rendering site-of-service and the contractual relationship between the practice and the facility — automatically, for every claim.

Radiology Benefit Managers (RBMs) like Evolent Health, AIM Specialty Health, and National Imaging Associates manage prior authorization for advanced imaging on behalf of payers. Each RBM has its own clinical criteria, portal, and turnaround standards.

MedCods manages RBM authorizations through a dedicated radiology PA workflow:

  • Automatic identification of which RBM manages PA for each payer/plan combination
  • Submission of PA requests to the appropriate RBM portal with clinical documentation extracted from the ordering provider’s EHR
  • Status tracking and follow-up until an authorization number is obtained
  • Authorization number attached to the claim at billing and verified against the approved CPT code and service date

This prevents the most common — and most expensive — radiology denial type: services rendered without the proper RBM authorization on file.

MedCods supports the full range of radiology CPT codes, including:

    • 70000–79999: Diagnostic Radiology (X-ray, CT, MRI, fluoroscopy, bone density)
    • 76506–76999: Diagnostic Ultrasound

78000–78999:

     Nuclear Medicine (including PET)
  • 77000–77799: Radiation Oncology (planning, simulation, treatment delivery)
  • Interventional Radiology: Including vascular, musculoskeletal, neuro, and body IR procedures across multiple CPT ranges

Our coding team includes credentialed radiology billing specialists (CIRCC-certified for interventional radiology) who understand the specific documentation requirements, modifier usage, and payer policies for each imaging modality and procedure type.

Teleradiology groups — where radiologists interpret studies remotely for hospitals and imaging centers across multiple states — face the same multi-state credentialing and billing complexity as other telehealth specialties, but at higher volume.

MedCods supports teleradiology groups with:

  • State-by-state licensure and payer enrollment tracking for each interpreting radiologist
  • Site-of-service billing logic that determines whether TC, 26, or global billing applies for each reading location
  • Multi-facility claim submission with the correct rendering and referring provider information for each study
  • Consolidated reporting across all reading sites so the group can see revenue performance by facility, modality, and radiologist

Interventional radiology (IR) involves minimally invasive, image-guided procedures — such as angiography, embolization, stent placement, tumor ablation, and drain placement. IR billing is particularly complex because:

  • Procedures often involve multiple components (guidance, diagnostic imaging, and therapeutic intervention) each with distinct CPT codes that must be coded together correctly
  • Add-on codes and bundling rules are extremely intricate — what can be billed separately versus what’s included in the primary procedure changes frequently
  • Medical necessity documentation requirements are stringent, as many IR procedures are high-cost alternatives to surgery
  • Prior authorization is almost universally required and must match the exact procedure performed
  • CIRCC (Certified Interventional Radiology Cardiovascular Coder) certification is the gold standard for IR coders

MedCods employs CIRCC-certified coders for interventional radiology clients to ensure accurate coding and maximum compliant reimbursement.

Enterprise Platform

Medical Billing Software for Billing Companies & CBOs

How is MedCods Enterprise different from standard billing software for billing companies?

Standard billing software is designed for individual practices managing their own billing. MedCods Enterprise is purpose-built for billing companies and centralized billing offices (CBOs) that manage billing on behalf of multiple provider clients simultaneously. Key differences:

  • Multi-client architecture: Manage hundreds of practice accounts in a single platform with complete data separation between clients
  • Client-level reporting: Generate performance dashboards, denial reports, and A/R summaries per client — not just globally across your portfolio
  • White-label capability: Present the platform under your own brand to your clients
  • Configurable workflows: Each client can have different payer rules, billing preferences, and reporting requirements maintained independently
  • Volume pricing for clearinghouse transactions: Enterprise-tier clearinghouse rates that reduce your cost per claim as volume grows
  • API access: For CBOs building proprietary workflow integrations or client portals on top of MedCods infrastructure

White-label medical billing software is a platform that a billing company licenses from a technology vendor (like MedCods) but presents to their own clients under the billing company’s brand — with the billing company’s logo, color scheme, and domain name. Clients see the billing company’s branded portal; MedCods operates invisibly in the background.

This allows billing companies to offer their clients a sophisticated technology experience — real-time claim tracking, denial dashboards, payment posting visibility, and analytics — without the capital cost of building proprietary software. The billing company retains full control of the client relationship and brand identity, while MedCods provides the underlying engine and infrastructure.

MedCods’ white-label tier includes custom domain hosting, branded email notifications, and configurable client-facing dashboards that can be restricted or expanded based on what each billing company wants their clients to see.

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