BMBankOfMedicare.comBilling University & Reimbursement Research

Research and Learning Methodology

BankOfMedicare.com separates official facts, simplified education, research-stage records, and claim-specific unknowns. A publication label describes source review, not the likelihood that a claim will be paid.

Publication states

Reviewed lesson
The lesson is mapped to named primary sources, has an editorial review date, and states its operational boundary.
Verified record
A code-level reimbursement statement is mapped to official sources, reviewed, and dated.
Source directory
The page identifies an authoritative research entry point but does not claim a complete code-level mapping.
Research stage
The code is discoverable, but no source-backed coverage determination is published or indexed.

Editorial workflow

  1. 1Start with the exact user question: claim type, payer program, date, setting, code, denial, or transaction.
  2. 2Locate the current primary source: CMS or HHS page, manual, code file, edit file, coverage record, form instruction, or contractor policy.
  3. 3Separate code validity, benefit, coverage, documentation, pricing, authorization, adjudication, and patient liability.
  4. 4Write a plain-language operational summary without turning a general rule into claim-specific advice.
  5. 5Attach source links and review dates, preserve unknowns, and exclude unverified records from the sitemap.
  6. 6Re-review after annual code updates, quarterly edit or fee releases, policy revisions, and source-backed corrections.

Copyrighted code-set boundary

CPT is maintained and copyrighted by the American Medical Association. The site teaches claim relationships and links to current sources; it does not reproduce a CPT codebook. Users must verify current licensed code content and payer instructions.

Fee schedule does not equal coverage

Fee schedule records are payment references. They do not establish benefit coverage, medical necessity, documentation sufficiency, supplier eligibility, correct coding, authorization, patient liability, or payment for an individual claim.

Privacy and intended use

Tools accept only de-identified scenario inputs. Do not enter names, Medicare identifiers, dates of birth, addresses, medical-record text, or other protected health information. Results are educational research support, not legal, coding, clinical, compliance, coverage, or payment advice.