Yes, optometry RCM services can improve NCR within 90 days, but only when the approach is built for optometry’s specific billing structure and not adapted from generic medical billing. Optometry practices routinely see Net Collection Ratio stuck in the 80 to 85% range, not because of poor front-desk performance, but because vision plan billing, medical […]
Yes, if your group is only tracking denial rate and not tracking what happens to those claims afterward. A multi-provider wound care group can post a completely normal denial rate and still be sitting on $100K to $250K a year in denied claims that were technically recoverable but never got worked to resolution before the […]
Medicare Advantage denials for skilled nursing facility stays are rising. The main driver: 99% of MA enrollees now sit in plans that require prior authorization for SNF admission. A June 2026 HHS OIG report found that MA organizations denied 12% of those requests overall, and that rate reached 40% for long-stay nursing home residents. Even […]
Most primary care groups forget the reimbursement tied to Transitional Care Management Codes CPT 99495 and 99496 because Transitional Care Management runs on a strict post-discharge clock, and the required patient contact window closes before front-desk staff even see the hospital discharge summary. What Actually Qualifies as Billable Transitional Care Management Codes Transitional Care Management […]
General surgery billing services close global period documentation gaps by verifying that every post-operative encounter is coded with the correct CPT modifier, tied to the original procedure’s 90-day or 10-day window, and supported by documentation that separates related care from unrelated, reimbursable services. Left unmanaged, this gap does not show up as an obvious problem […]
Outpatient physical therapy billing loses the most revenue in five places that never show up as a denial: time units rounded down instead of billed to the full 8-minute rule, the KX modifier threshold crossed without supporting documentation, modifier 59/XS left off legitimately separate procedures, re-verification skipped on authorized visit counts, and secondary payer coordination […]
For most multi-provider groups, the honest answer is yes. Once you add up salaries, benefits, software, training, and the claims nobody ever reworks, in-house billing usually costs more than outsourced revenue cycle management, even before you count the revenue that simply never gets collected. Most centers never run this comparison. They look at an outsourcing quote, […]
For most cardiology practices, yes. Outsourced cardiology scribing typically runs 30-40% less than an in-house hire once you account for salary, benefits, training time, and turnover, and it solves a problem in-house hiring can’t: keeping the same documentation standard across echo labs, stress test suites, and multiple providers without a new hiring cycle every time […]
Medicare Advantage EEG downcoding happens when plans downcode neurology EEG claims because their algorithmic review systems scan interpretation reports for specific structured language, not clinical judgment. When a report is written the way physicians are trained to write it, in clinical narrative, the algorithm cannot find what it is looking for, so it defaults to […]
Medical Scribing Services solve a problem most physician groups don’t realize is a revenue problem: notes that get finished thin, late, or after-hours because providers can’t document and see patients at the same pace. For a solo doctor, that’s a personal time crunch. Across a multi-provider group, it’s a compounding billing gap, since a thinner […]
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