The Transitional Care Management Codes Most Practices Forget, and How Primary Care Billing Services Catch Them

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 […]

Why General Surgery Billing Services Are Key to Closing Global Period Documentation Gaps

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: Where Does the Revenue Leak?

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 […]

Is In-House Billing Costing More Than Outsourced Revenue Cycle Management?

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, […]

Is Outsourced Cardiology Scribing More Cost-Effective Than In-House Hires?

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 […]

Why Is Medicare Advantage Downcoding Your Neurology EEG Claims?

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 for Physician Groups

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 […]

How to Choose the Best Orthopedic Billing Services?

To choose the best orthopedic billing services, look for a partner staffed by certified orthopedic coders who track global surgery periods claim by claim, apply modifiers correctly the first time, report denial rates and days-in-AR every month, and price their service as a percentage of what they actually collect for you. A generalist billing vendor […]

Is Your Family Practice Reimbursement Model on the Winning or Losing Side of CY2026’s Payment Split?

Family Practice Reimbursement is shifting fast under CY2026’s split payment structure. Most multi-provider Family Practice Billing Services groups land on the winning side of CY2026’s payment split by structure, not by luck: the bulk of family practice revenue runs through E/M and chronic care codes that CMS specifically exempted from this year’s biggest cut. But […]

What Makes Ophthalmology Billing So Complex to Manage?

Ophthalmology billing is complex because it runs on two coding systems at once (Eye codes and E/M codes), stacks a 92-day global surgical period on top of one of Medicare’s highest-volume procedures, and demands drug-level accuracy for injectable medications that cost more per dose than a typical office visit. A federal watchdog just flagged $124 […]

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