Straight-talking articles on billing and revenue cycle, credentialing, state licensing and healthcare technology, written by the people who do this work every day for practices across all 50 states.
Insurance eligibility verification is the first real checkpoint in the revenue cycle, and getting it wrong is one of the most common, most preventable causes of…
Read MoreThe CDC reports that one in five U.S. children aged 3 to 17 has a diagnosable mental, behavioral, or de and fewer than 10 child and adolescent psychiatrists…
Read MoreUnitedHealthcare announced on May 5, 2026 that it would eliminate an additional 30 percent of its remaining prior authorization requirements, with the changes…
Read MoreCMS's CY 2027 Medicare Physician Fee Schedule proposed rule includes a provision that would cut payment by 50 percent on same-day E/M visits billed with modifier 25…
Read MoreNew data out of England shows a 36 percent rise in children reaching emergency departments in mental health crisis since 2019, with the fastest growth among…
Read MoreDays in A/R is the single most diagnostic number in a medical practice's revenue cycle, and most practices are running well above where they should be. This article…
Read MoreStarting December 31, 2026, states must redetermine Medicaid eligibility for expansion enrollees every six months instead of annually, doubling the frequency of…
Read MoreICD-11 isn't ICD-10-CM with more codes bolted on. It runs on a fundamentally different structure, post-coordinated stem and extension codes, a reorganized chapter…
Read MoreClean claim rate is the single clearest early indicator of whether a practice's front-end revenue cycle is working. This article covers exactly what the metric…
Read MoreReading about denials, credentialing delays and licensing paperwork is one thing. Handing them to a team that does it every day is another. Tell us where it hurts and we will tell you honestly what we would do.
