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 […]
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 […]
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 […]
Probably not, and that’s normal. Most orthopedic groups and multi-surgeon facilities carry a meaningful chunk of orthopedic AR sitting past 90 and 120 days heading into Q4, largely because joint and spine procedures carry 90-day global billing periods, implant documentation delays, and workers’ comp cases that age slower than routine claims. The real question isn’t […]
G0511 was replaced by two paths: RHCs and FQHCs now either bill individual CPT and HCPCS care management codes per service, or bill the three-tier Advanced Primary Care Management (APCM) codes — G0556, G0557, and G0558 — introduced for CY2025 and expanded further under CY2026 rules. What Was G0511, and Why Did CMS Retire It […]
Yes. For most multi-provider practices and facilities, denial write-offs are one of the largest hidden drains on EBITDA, often erasing 3% to 5% of net patient revenue every year. Unlike a denied claim that gets reworked and paid, a write-off is money your facility has permanently given up, and it rarely shows up as a […]
Graft application billing has not kept pace with the CTP rule change for most wound care groups, and the gap shows up as underpayment on every claim still coded and documented the old way. CMS restructured how cellular and tissue-based products (CTPs) are paid under the CY 2026 Physician Fee Schedule Final Rule, moving most […]
The CY2026 ASC Payment Rule adds 289 procedures to the ASC Covered Procedures List through revised coverage criteria, plus 271 additional codes carried over as CMS phases out the Inpatient Only List, bringing the total number of newly ASC-eligible procedures to more than 500. What Changed in the CY2026 ASC Payment Rule? CMS finalized the […]
Yes, for most healthcare organizations, Root Cause Denial Analysis is missing, and that gap is exactly why the same denials keep resurfacing month after month. It is the practice of tracing every denied claim back to the operational or clinical breakdown that caused it, rather than reworking the claim and moving on. Most facilities treat […]
Yes, for most multi-provider practices and facilities, medical necessity denials are one of the largest, most preventable sources of revenue leakage on the books. They happen when a payer decides that the documentation submitted doesn’t justify the service billed, even when the care itself was completely appropriate. The result is a stalled claim, a frustrated […]
Connect with us by filling out this form. Let’s tailor a
solution that fits your needs perfectly.
Specialities
Services
Resource Center
Pricing
About
Contact
