If you’re vetting an optometry billing company, ask these six questions first: How do you separate medical from vision-plan claims? What’s your clean claim rate for eye-care CPT codes? How do you handle coordination of benefits? What’s your Days in AR for optometry clients specifically? Can you show real client metrics, not averages? And who […]
The right Medicare participation status isn’t the same for every practice. While our PAR and Non-PAR overview covers the federal rules that apply to everyone, this guide looks at the practical factors that should drive your practice’s decision: specialty, patient mix, and administrative capacity. Specialties Where Non-PAR Is More Common Non-PAR and private-contracting elections tend […]
Here is the fact most practices discover eighteen months too late: the majority of payer downcoding never appears as a denial at all. When UnitedHealthcare, Cigna, Anthem, or a BCBS plan downcodes a claim, one of two things happens. Either the claim is denied with CARC CO-150 — “payer deems the information submitted does not […]
To choose the best Neurology Billing Company, compare vendors on five criteria: neurology-specific coding experience, clean claim rate, denial management process, compliance standards, and pricing transparency. A Neurology Billing Company that performs well across all five areas will consistently reduce denials, speed up reimbursements, and give your practice steady, predictable cash flow. Neurology billing is […]
Deciding whether to enroll as a Medicare PAR or Non-PAR provider is only half the equation — actually changing that status requires following CMS timelines and paperwork precisely. This guide walks through the enrollment mechanics referenced in our complete overview of PAR and Non-PAR providers so your practice can make a status change without delays […]
ICD 10 vs CPT confusion is no longer really about code accuracy at all. The real issue is the link between the two. A claim can carry a flawless ICD-10 diagnosis code and a flawless CPT procedure code and still get denied for “medical necessity not met,” because Medicare and commercial payers don’t approve codes […]
Internal medicine AR is growing despite stable patient volume because the revenue cycle failure is not happening at the encounter level — it is happening at the payment collection layer, where payer variance underpayments, CCM billing gaps, E/M downcodes, and prior authorization holds are each adding days to AR on claims that were submitted correctly […]
AR Cleanup for Wound Care Groups starts with one uncomfortable fact: most aged receivables in wound care don’t come from bad debridement technique. They come from unspecified ICD-10 codes that never should have left the coding queue. If your multi-site group is sitting on 90+ day AR that keeps growing even as case volume climbs, […]
Under-Coding vs Over-Coding is the single biggest coding decision that determines whether your facility keeps its revenue or hands it to CMS on a silver platter. Under-coding happens when a coder assigns a lower-level code than the documentation supports, which quietly erases revenue every single day. Over-coding happens when a coder bills a higher-level code than the […]
The Top 10 ICD-10-CM Coding Errors costing healthcare organizations the most revenue in 2026 are unspecified code overuse, missing 7th-character extensions, upcoding/undercoding, sequencing mistakes, mismatched laterality, outdated code use after annual updates, missing Excludes1/Excludes2 checks, incomplete documentation-to-code linkage, modifier-coding conflicts, and failure to apply new payer-specific edits. Each one triggers denials, audit exposure, or silent underpayment, […]
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