Chart Auditing & DRG Review: Identifying Hidden Revenue in Clinical Documentation
In the increasingly complex world of healthcare reimbursement, clinical documentation is more than just a record—it’s a financial asset. Hospitals,…
Medical Billing Blog
Out-of-Network Negotiation Services: When and How to Leverage Them Effectively
As healthcare becomes increasingly complex, many medical practices find themselves providing services to patients whose insurance plans do not include…
Telehealth Reimbursements Beyond CPT: How Payers Handle POS, Audio‑Only & Device-Based Services
Telehealth is no longer a temporary solution—it’s a core part of modern care delivery. But while CPT and HCPCS codes…
Navigating the No Surprises Act: How to Manage Out‑of‑Network Billing and Patient Estimates
The healthcare landscape has long struggled with surprise medical bills—unexpected charges that patients receive after unknowingly receiving care from out-of-network…
HCPCS & CPT Code Updates for 2025: What Specialty Practices Must Know
Every year, the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) release critical updates to…
Real-Time Eligibility Verification: Reducing Denials at the Front Door
In today’s healthcare revenue cycle, denials are one of the biggest obstacles to getting paid on time—and in full. According…
Credentialing & Contracting in 2025: Trends and Pitfalls to Avoid
In the ever-evolving landscape of healthcare administration, provider credentialing and payer contracting continue to serve as the foundation of operational…
Harnessing Revenue Cycle Analytics: Key KPIs Every Practice Should Monitor
In today’s data-driven healthcare ecosystem, running a successful medical practice isn’t just about providing quality care—it’s also about ensuring your…
Upcoding vs. Compliance: Guardrails to Avoid Medicare Fraud Allegations
As healthcare reimbursement grows more complex and regulatory oversight intensifies, providers must tread carefully between accurate billing and the risk…
Telehealth Billing 2.0: Codes, Modifiers & Compliance Post‑Pandemic
The COVID-19 pandemic accelerated the adoption of telehealth like never before. What was once a convenience quickly became a necessity—reshaping…