Denial management often gets reduced to a task of fixing rejected claims. Yet, it is much more than that. It involves uncovering the root causes behind revenue loss and taking steps to prevent it. In the complex world of U.S. healthcare revenue cycle management (RCM), denials frequently occur due to eligibility problems, missing authorizations, bundling errors, or documentation issues. Understanding these causes and addressing them systematically can significantly improve cas

Starting a new year means setting fresh goals and planning for success. For healthcare providers, one of the biggest challenges is managing billing efficiently to ensure steady cash flow and maximize revenue. Your billing process should support your practice, not slow it down. As 2026 begins, adopting a clear, controlled, and high-performing revenue cycle can make a significant difference from day one. This post explores how clean billing, quick payments, low denials, and rev

Healthcare practices vary widely in size and structure, from solo practitioners to large healthcare networks. Each faces unique operational challenges that affect patient care, staff efficiency, and financial health. Finding strategies that work across this spectrum can improve outcomes and reduce stress for everyone involved. This post explores practical ways to improve operations in healthcare settings of all sizes. Understanding the Needs of Different Practice Sizes Small

Patient billing is a critical part of healthcare revenue management. It involves collecting the patient’s financial responsibility after insurance processes the claim or when services fall outside coverage. This process directly affects cash flow, patient trust, and compliance with regulations. Getting patient billing right can improve collections, reduce bad debt, and maintain a positive relationship between providers and patients. Understanding what patient billing includes

Choosing the right health savings option can save you money and reduce stress when medical expenses arise. Two popular choices are Health Reimbursement Arrangements (HRA) and Health Savings Accounts (HSA). While both help manage healthcare costs, they work differently and suit different needs. This post explains how HRAs and HSAs compare, helping you decide which fits your situation best. What is a Health Reimbursement Arrangement (HRA)? An HRA is an employer-funded plan that

Telehealth has become a critical part of healthcare delivery, especially after recent shifts in how care is accessed. With this growth, accurate billing for telehealth services is essential to avoid claim denials and compliance issues. Two common modifiers used in telehealth billing are Modifier 93 and Modifier 95. Although they may seem similar, they serve different purposes and apply to different types of services. Misusing these modifiers can lead to billing errors, delaye

Medical billing and coding involve many details that affect how healthcare providers get paid. Among these details, modifiers play a crucial role. Two common modifiers you might encounter are the GV and GW modifiers. Understanding what these mean and when to use them can help avoid claim denials and ensure accurate reimbursement. What Are Modifiers in Medical Billing? Modifiers are two-character codes added to CPT (Current Procedural Terminology) or HCPCS (Healthcare Common

Medical billing and coding can be confusing, especially when it comes to understanding the different code sets used in healthcare. Two of the most important coding systems are CPT and HCPCS codes. Both play a crucial role in documenting medical services and procedures, but they serve different purposes and follow distinct rules. Knowing how these codes differ helps healthcare providers, coders, and billers ensure accurate claims and proper reimbursement. This post breaks down

Mental health has gained increasing attention in healthcare, yet its influence on medical billing often remains overlooked. Medical billing professionals play a critical role in ensuring that mental health services are accurately documented and reimbursed. Understanding how mental health awareness shapes billing practices can improve patient care, reduce errors, and support healthcare providers. How Mental Health Awareness Changes Medical Billing Mental health awareness affec