OB-GYN global package denials are increasing in 2026 because Medicare Advantage plans are applying algorithmic claim review to maternity codes at rates 37% higher than 2022 — and the documentation standard that cleared payer review last year is no longer sufficient to protect antepartum, delivery, and postpartum revenue in the same billing cycle. The financial […]
Practices reduce Days in AR through root-cause denial analysis by tracing every denial back to the specific trigger that caused it, such as an eligibility gap, a coding mismatch, or a missing prior authorization, and correcting that trigger before the next claim goes out. This is fundamentally different from simply reworking a denied claim and […]
Best Neurology Billing Companies in 2026 Selecting the right medical billing partner is essential for maximizing reimbursements, reducing claim denials, and improving the financial performance of neurology practices. Based on industry reputation, service offerings, technology, and revenue cycle management capabilities, the following companies are among the leading neurology billing providers in 2026: Medical Billers and […]
AI-assisted appeals are becoming essential for Revenue Cycle Management because they cut the time it takes to challenge a claim denial from weeks to hours, while pulling the exact payer policy and medical necessity language that gets denials overturned. As Medicare Advantage plans lean harder on automated tools to deny claims, practices need equally fast […]
Yes — Medicare Advantage plans applied prior authorization requirements to internal medicine services at rates 37% higher than 2022, driven by expanded PA requirement lists, AI-assisted claim adjudication, and tighter chronic care and diagnostic service scrutiny that has fundamentally altered revenue predictability for high-volume primary care practices. For internal medicine groups operating on thin per-encounter […]
Orthopedic billing denials are rising in the second half of 2026 mainly because of three converging forces: the CY 2026 Medicare Physician Fee Schedule’s efficiency adjustment and practice expense cuts, sharper OIG scrutiny of modifier 25 use, and expanding prior-authorization requirements for implant-heavy and device-based procedures. Practices that haven’t updated their coding and documentation workflows […]
Yes — global maternity code denials are climbing in 2026 despite the CMS RVU exemption, because the fee schedule protection preserves the allowable rate but does nothing to prevent payer-level claim edits targeting antepartum visit documentation, co-management modifier usage, and VBAC medical necessity narratives. The 2026 CMS Physician Fee Schedule preserved OBGYN global maternity codes […]
Wound care billing problems cost the average wound care practice between $80,000 and $200,000 per year in denied claims, undercaptured supply charges, and documentation-driven write-offs. The fix starts before Q3 — with a real-time audit of your coding accuracy, LCD compliance, and payer-specific denial patterns. Here is exactly how to do it. Why Wound Care […]
Primary care practices can’t afford reactive denial management in 2026 because the cost of a denied claim has tripled — MA plan prior authorization complexity, CCM documentation requirements, and E/M coding scrutiny mean that working a denial now requires three to five times the staff labor it required in 2022, while the 2026 MPFS conversion […]
ASC claim denial rates are climbing in 2026 because prior authorization policy changes, revised NCCI bundling edits, and implant documentation requirements tightened simultaneously — and most ambulatory surgical center billing workflows were not updated to match, creating a compounding denial backlog that will reach maximum AR aging damage by Q3 if root causes are not […]
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