Many medical practices feel confident about their billing process. Payments arrive regularly, and the biller seems reliable. Yet, there is often a nagging feeling that something is not quite right. This feeling usually points to a hidden problem: the true state of your Accounts Receivable (AR) is unclear. Without a clear view, revenue quietly slips away through small, overlooked issues. This post explains why a billing audit is necessary and how it can reveal silent revenue l

World Pharmacist Day: Celebrating the Vital Role of Pharmacists in Healthcare World Pharmacist Day offers a chance to recognize the vital contributions pharmacists make to healthcare systems worldwide. These healthcare professionals do much more than dispense medications. They ensure safe and effective treatment, provide expert advice, and support patients through complex health challenges. Understanding their role helps us appreciate how pharmacists improve health outcomes e

Denied claims and aging accounts receivable (AR) quietly drain millions of dollars from healthcare providers every year. With denial rates hovering between 10 and 15 percent and a significant portion of AR remaining unpaid beyond 90 days, many organizations face a hidden revenue leak that disrupts cash flow and increases administrative burdens. Understanding the causes and consequences of these challenges is essential for recovering lost revenue and improving financial health

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 covers all charges that the patient is responsible for after insurance has paid its share. These charges can come from several sources: Copay : A fixed amount the patient pays at the time of service. Deductible : The amount the patient must pay before insurance starts covering costs. Coinsurance : A percentage of the costs the patient shares with the insurer. Non-covered services : Services not included in the patient’s insurance plan. No-show fees : Charges f

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