Specialities
Michigan leads the nation with a 63.7% Medicare Advantage penetration rate as of August 2026 — the only state above 60%. That means a larger share of Michigan’s SNF admissions run through MA prior authorization than in any other state. This is driving a sharp rise in SNF Auth Denials statewide. Combined with a Certificate […]
Michigan TCM billing is not built for Medicare Advantage rules if it still runs on fee-for-service assumptions. At 63.7% MA penetration, the highest of any US state, most Michigan Medicare patients have their TCM billing claims adjudicated by a private MA carrier, not by the state’s fee-for-service Medicare Administrative Contractor. Getting this right starts with […]
Florida general surgery billing services close the post-op documentation gap Medicare is watching. The fix: every operative note and post-op encounter note must independently support the modifier billed, not just show that the claim carried a modifier. First Coast Service Options, the Medicare Administrative Contractor for Florida, and CMS’s own CERT program are both increasingly […]
Texas’s 95-Day Filing Window is real and unforgiving, but it is only one clock. Texas practices are tracking the wrong one: the 95-day TMHP filing deadline gets all the attention, and the bigger AR problem is that most practices use it as their only reference point, missing the separate 30-to-45-day payer payment clock that Texas […]
NY ASC facility fee synchronization is the practice of cross-checking a surgeon’s professional claim against the ASC’s facility claim for the same case, and without it, New York surgery centers lose $1,500 to $5,000 in uncollected facility fees per procedure, a risk amplified by the fact that New York runs more orthopedic case volume per […]
Medicare Advantage EEG Downcoding is happening across Texas neurology practices because Novitas Solutions, the Medicare Administrative Contractor for Jurisdiction H, requires interpretation reports to document one of a defined set of covered clinical indications, and most narrative-style EEG reports never state their findings in those exact structured terms. When a Texas practice’s report doesn’t visibly […]
Florida dermatology practices face a regulatory calendar collision this fall that practices in most other states do not: a federal payment rule, a state Medicaid managed care structure that was rebuilt eight months ago, and the country’s most concentrated Medicare Advantage enrollment season, all landing in the same quarter most vendor contracts require renewal notice. […]
Compare Cardiology Billing Companies in California using more than percentage fees. A billing company may quote a lower rate, but weak denial follow-up, slow AR recovery, limited cardiology coding expertise, or poor payer reporting can mean that lower fee never translates into better financial performance. California cardiology practices should evaluate billing partners on coding expertise, […]
A gastroenterology practice can collect millions of dollars each year and still leave significant revenue uncollected. The problem may not be patient volume. It may be what happens between documentation, coding, claim submission, payer adjudication, payment posting, and A/R follow-up. For Florida GI practices, evaluating a billing company by total collections alone is not enough. […]
For practices considering Neurology Billing in Florida, changing vendors should involve more than signing a new contract. The transition should protect active claims, preserve billing history, maintain payer workflows, and establish clear responsibility for outstanding accounts. A structured transition gives the new billing partner the information needed to improve performance without disrupting existing revenue. Switching […]
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