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Medical Billing Services

Keeping Your Practice Profitable During Pandemic

Keeping Your Practice Profitable During Pandemic

Maximizing profitability and practice collections is the main objective for successful medical practices. In a time of this pandemic, however, practice profitability became even more critical. Your practice’s profitability depends on a variety of factors that aren’t always under your control, particularly during times of crisis. But rather than looking at this pandemic situation as […]

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Reducing Medical Billing Staff Burnout

Reducing Medical Billing Staff Burnout

According to MGMA’s (Medical Group Management Association) report, amongst the COVID-19 pandemic, burnout among medical billing staff becomes an overwhelming problem. MGMA reported a combined 30% turnover rate specifically among front office and operational staff, the highest of any other healthcare career category. Continuously changing payer policies and reimbursement guidelines put additional pressure on medical […]

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Proposed Changes to Shared Visit Billing

Proposed Changes to Shared Visit Billing

Basics of Shared Visit Nurse practitioners (NPs) or physician assistants/physician associates (PAs) and physicians sometimes ‘share; patient visits. A shared visit which is also called a split visit is one where both types of clinicians participate in evaluating and managing a patient on a given day. The Centers for Medicare & Medicaid Services (CMS) defined […]

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Basics of Value-Based Contract (VBC)

Basics of Value-Based Contract (VBC)

Defining Value-Based Contract (VBC) A value-based contract (VBC) is a written contractual arrangement between parties in which the payment for health care goods and services is tied to predetermined, mutually agreed upon terms that are based on clinical circumstances, patient outcomes, and other specified measures of the appropriateness and effectiveness of the services rendered. In […]

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Avoiding Healthcare Fraud and Abuse

Avoiding Healthcare Fraud and Abuse

Providers face multiple healthcare fraud and abuse laws at the local, state, and federal levels. Fraud and abuse cases in the healthcare industry cost billions of dollars a year. Healthcare fraud and abuse situations include submitting false claims; billing for medically unnecessary services; billing and coding errors; billing for services that were provided by unlicensed […]

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Can Providers Waive Copays and Deductibles?

Can Providers Waive Copays and Deductibles?

Yes, but not routinely. A provider can waive or stop collecting a patient’s share for a real financial hardship, decided case by case and documented. Routinely waiving copays and deductibles, especially for Medicare and other federal program patients, can violate the Anti-Kickback Statute, the Civil Monetary Penalties Law, and your payer contracts. Healthcare service providers […]

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Understanding Anti-Markup Rule for Diagnostic Tests

Understanding Anti-Markup Rule for Diagnostic Tests

Last updated: October 21, 2026 The Anti-Markup Rule is a Medicare billing rule that stops a billing physician or supplier from profiting on diagnostic tests performed by someone outside their practice. If your practice orders imaging, cardiology, neurology or other diagnostic tests and bills Medicare for the technical component (TC) or professional component (PC), you […]

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Surprise Billing: What Providers Must Know

Surprise Billing: What Providers Must Know

Requirements Related to Surprise Billing Biden-Harris Administration, through the U.S. Departments of Health and Human Services (HHS), Labor, and Treasury, and the Office of Personnel Management, issued ‘Requirements Related to Surprise Billing; Part I, ‘an interim final rule that will restrict excessive out of pocket costs to consumers from surprise billing and balance billing. Surprise […]

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Busting Common Medical Billing Myths

Medical Billing Myths

Medical billing is the most important yet underestimated part of your healthcare organization’s revenue cycle. However, there are a few things that are commonly believed about them that just aren’t true! These myths range from considering medical billing as a data entry process to misconceptions about outsourcing. We wanted to clear up some of the […]

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