Insights & Resources
Practical guidance on revenue cycle, coding, compliance, and the business of healthcare.
One missing signature can bring a provider enrollment application to a standstill and potentially put thousands of dollars in reimbursement at risk. Learn why practices need better visibility, communication, and tracking throughout the credentialing and enrollment process.
Provider enrollment is more complicated than ever. From CAQH and PECOS to payer portals, practice locations, revalidations, EFT and more, learn why keeping provider information accurate across multiple systems is critical to protecting your practice’s revenue.
Is your billing company giving you data, or actual revenue intelligence? Discover the five reports every physician practice owner should review to understand A/R, denials, provider performance, adjustments, underpayments, and where revenue may be getting lost.
A strong collection rate doesn’t always mean your practice is capturing all the revenue it has earned. Missed charges, undercoding, payer underpayments, preventable denials, and hidden write-offs can quietly create revenue leakage, even when your billing reports look healthy. Learn what practice owners should be looking at beyond collections to uncover where revenue may be slipping through the cracks.
An aging report tells you how much is outstanding and how old it is. It rarely tells you why the money is still sitting there — and the claim that never entered the system does not appear at all.
One orthopedic patient can generate an office visit, X-rays, an injection, a brace, fracture care, and surgery — all for the same condition. The costly errors are rarely the obscure rules; they are the everyday ones a practice repeats hundreds of times.
Ask five people when critical care is billable and you will hear five answers. It is not the ICU, not the ventilator, and not a severe-sounding diagnosis — it is the patient's risk, the physician's work, and the qualifying time.
A global period is not a 10- or 90-day "do not bill" window, and it is not a free pass to add a modifier either. Here is what the surgical package actually covers, what it does not, and the six questions that settle any encounter.
"We can't bill it — the patient is still in the global." Sometimes that's right. Sometimes it hands away a medically necessary service that was never part of the surgery. Here's when Modifier 24 applies — and when it doesn't.
