Underpayments/under-reimbursement represent a major source of revenue leakage for healthcare organizations. Underpayments have become common and are often “silent”, meaning that payment is received...
2026 CPT Code Updates: What Providers Need to Know
The 2026 CPT codes updates, effective January 1, 2026, streamline reporting for advanced digital health, improve clarity for complex procedures, and align coding with evolving technology and patient...
IVF Billing and Coding: A Step-by-Step Guide for Providers
In-vitro fertilization (IVF) is one of the most advanced reproductive treatments available today, offering hope to patients struggling with infertility. While clinical expertise is vital for...
A Clear Comparison: Retro Authorization vs Prior Authorization
In healthcare administration and medical billing, authorization requirements remain one of the most important yet commonly misunderstood components. Insurance companies rely on authorization to...
How to Avoid Gastroenterology Medical Billing Errors
Gastroenterology billing is challenging due to complex coding requirements, billing multiple payers, limited insurance coverage, and other challenges like documentation requirements, changing...
Exploring the Impact of Retro Authorization on Revenue Cycle
In today’s complex healthcare billing landscape, authorizations play a crucial role in ensuring smooth financial operations. Healthcare providers and billing departments need to understand how...
Tips for Avoiding Prior Authorization Delays in Healthcare
In today’s healthcare environment, balancing quality patient care with growing administrative demands is one of the biggest challenges. Among these demands, few are as time-consuming and frustrating...
How to Report Systemic Lupus Erythematosus with the Correct ICD-10 Codes: A Complete Guide
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organ systems and can present with a wide range of symptoms. For healthcare providers and medical coders,...
Seven Common Claim Denial Reasons and Effective Mitigation Strategies
When it comes to the world of healthcare revenue cycle management, insurance claim denials are a major pain point that can significantly disrupt cash flow. Not only do they delay reimbursements, but...