Yes, your GI Billing Process should already be under review for CPT 2027. The AMA has approved significant CPT changes taking effect January 1, 2027, including new Category I reporting for endoscopic submucosal dissection in the upper and lower GI tract. The final CPT 2027 code set is still moving through its publication cycle, so […]
Appeals vs Resubmissions comes down to one question: was the claim denied because of a payer judgment call, or because of a fixable error on the claim itself? Resubmission is the right move when a claim was rejected for a correctable mistake: a typo, a missing modifier, an outdated NPI. An appeal is the right […]
AI vs Human Medical Coders isn’t a contest with one winner. AI wins on speed and consistency for high-volume, low-complexity claims. Human coders win on judgment for complex, high-dollar, and audit-sensitive cases. The groups seeing the best financial results in 2026 aren’t choosing one over the other — they’re building a coding model that routes […]
For most multi-provider OBGYN groups collecting $1 million or more per month, OBGYN underpayments cost between 2 and 4 percent of collected revenue across the first half of 2026, and almost none of it shows up on a standard denial report. Underpayments are not denials. They are claims paid, posted, and closed out below the […]
AI in Revenue Cycle Management is not a magic fix that replaces your billing team overnight — it is a governed, data-driven layer that predicts denials, automates prior authorizations, and protects margins when it is implemented correctly. That single distinction separates the organizations seeing real returns from the ones stuck paying for software nobody trusts. […]
Cardiology Billing Services are only as good as the numbers behind them, and measuring performance starts with a small set of metrics that tell you exactly where revenue is being protected or lost. The direct answer: track clean claim rate, denial rate, days in AR, and net collection rate every month, and compare each against […]
Medicare Advantage denials are the single largest driver of legacy AR in internal medicine because MA plans deny roughly 17% of submitted claims, more than double traditional Medicare’s 8%, and apply prior authorization to internal medicine services at rates 37% higher than in 2022. For a $4 million group, that gap represents roughly $680,000 in […]
The direct answer: rising Gastroenterology AR is almost never a volume problem. It is a coding, denial, and follow-up problem that compounds month over month until old AR recovery becomes a full-time project instead of a routine task. Gastroenterology AR grows even when patient volume is strong because the revenue leak usually happens after the […]
A strong Wound Care Revenue Cycle Model is the system a clinic uses to turn patient care into paid claims, covering everything from insurance verification and coding to denial appeals and collections. In 2026, this system matters more than ever because Medicare has rewritten the rules for how skin substitutes, debridement, and hyperbaric therapy get […]
Yes — for most multi-provider OBGYN groups, claims sitting in accounts receivable past 120 days routinely contain six figures in recoverable OBGYN revenue, often tied to global maternity billing errors, IUD and Nexplanon supply codes, and timely filing gaps that never got worked before write-off. What Counts as “Legacy” AR in an OBGYN Practice Legacy […]
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