We’re seeing an increased trend that is directly targeting the financial health of outpatient practices. If your office visit revenue feels "off" but you can't pinpoint why, you may be a victim of automatic downcoding.  What we’re seeing across many practices is a systemic, quiet reduction of reimbursements caused by downcoding E/M claims without any prior notification  No Warning, No Explanation: Payers are not notifying physicians or billing staff that a claim has been down

Billing for interpreter services comes up every time a clinic gets a big invoice from a translation vendor. We frequently get questions...

Recently, AAPC released a podcast  focusing on the proper and effective use of the complexity add-on code G2211. Understanding this code...

The CMS telehealth extension has been a rolling story since the pandemic. CMS first used emergency waivers to allow telehealth use...

There’s nothing more frustrating for a healthcare practice than receiving a denial on a claim that should have been approved. Denied...

In the hectic environment of medical practices, it's easy for claims to slip through the cracks, leaving services unbilled and revenue...

Selecting the correct Evaluation and Management (E/M) code is a vital part of documenting patient visits accurately and ensuring proper...

Out-of-office encounters—such as telemedicine visits, remote monitoring, or procedures conducted outside of the traditional clinical...

In primary care, it’s easy to focus on office visits and routine evaluations, but many practices overlook the importance of accurately...

Primary care practices often face challenges when billing for services provided during an annual physical, especially when patients...

In today’s healthcare landscape, managing insurance claim denials is one of the biggest challenges practices face. Denials don’t just...

The Challenges of Prior Authorizations The prior authorization process is designed to ensure that treatments and services are medically...

What Is Revenue Leakage? Revenue leakage refers to the loss of income that a medical practice experiences when it doesn’t fully capture...

In the day-to-day operations of a medical practice, accurate documentation is key—not just for clinical care, but also for billing and...

A clean and well-managed accounts receivable (AR) system is more than just a reflection of your billing team's efficiency—it’s the...

In the world of medical billing, automation is often seen as a solution to many time-consuming tasks. One such task is the posting of...

Introduction: Chronic Care Management (CCM) presents an invaluable opportunity for healthcare practices to deliver enhanced care to...

As the medical billing landscape continues to evolve, staying informed about the latest trends is crucial for maintaining efficient...

Running a successful medical practice involves more than just providing excellent patient care. It also requires efficient management of...

In the realm of medical practice management, certain tasks often take center stage due to their perceived complexity or immediate impact...