Outsourced GI Billing vs In-House Billing: Which Is Better?

For most gastroenterology practices, outsourced GI Billing is the better option because it reduces denials, lowers staffing costs, and keeps pace with the complex coding rules tied to colonoscopies, endoscopic procedures, and screening versus diagnostic billing. In-house billing can still work well for large multi-provider groups with the volume to support a dedicated team, but […]

Questions to Ask Before Hiring an Optometry Billing Company

If you’re vetting an optometry billing company, ask these six questions first: How do you separate medical from vision-plan claims? What’s your clean claim rate for eye-care CPT codes? How do you handle coordination of benefits? What’s your Days in AR for optometry clients specifically? Can you show real client metrics, not averages? And who […]

Should Your Specialty Practice Go Non-PAR? A Medicare Decision Framework

The right Medicare participation status isn’t the same for every practice. While our PAR and Non-PAR overview covers the federal rules that apply to everyone, this guide looks at the practical factors that should drive your practice’s decision: specialty, patient mix, and administrative capacity. Specialties Where Non-PAR Is More Common Non-PAR and private-contracting elections tend […]

Payer Downcoding Denials: How Physician Groups Detect, Appeal, and Prevent Them in 2026

Payer downcoding denials happen when a payer reduces a billed E/M level, most often 99214 or 99215, either by denying the claim with CO-150 or by quietly paying it at a lower level as if it were clean. Groups catch both by running a CO-150 report and a submitted-versus-paid code report by payer, then appealing […]

How to Choose the Best Neurology Billing Company

To choose the best Neurology Billing Company, compare vendors on five criteria: neurology-specific coding experience, clean claim rate, denial management process, compliance standards, and pricing transparency. A Neurology Billing Company that performs well across all five areas will consistently reduce denials, speed up reimbursements, and give your practice steady, predictable cash flow. Neurology billing is […]

Medicare PAR Enrollment Guide: How to Change Your Participation Status Step-by-Step

Deciding whether to enroll as a Medicare PAR or Non-PAR provider is only half the equation — actually changing that status requires following CMS timelines and paperwork precisely. This guide walks through the enrollment mechanics referenced in our complete overview of PAR and Non-PAR providers so your practice can make a status change without delays […]

ICD 10 vs CPT: Why Medical Necessity Denials Happen Even With Correct Codes

ICD 10 vs CPT confusion is no longer really about code accuracy at all. The real issue is the link between the two. A claim can carry a flawless ICD-10 diagnosis code and a flawless CPT procedure code and still get denied for “medical necessity not met,” because Medicare and commercial payers don’t approve codes […]

Why Is Your Internal Medicine AR Growing Even Though Patient Volume Is Stable?

Internal medicine AR is growing despite stable patient volume because the revenue cycle failure is not happening at the encounter level — it is happening at the payment collection layer, where payer variance underpayments, CCM billing gaps, E/M downcodes, and prior authorization holds are each adding days to AR on claims that were submitted correctly […]

AR Cleanup for Wound Care Groups: Fixing the Specificity Errors Draining Multi-Site Margins

AR Cleanup for Wound Care Groups starts with one uncomfortable fact: most aged receivables in wound care don’t come from bad debridement technique. They come from unspecified ICD-10 codes that never should have left the coding queue. If your multi-site group is sitting on 90+ day AR that keeps growing even as case volume climbs, […]

Under-Coding vs Over-Coding: How to Avoid Lost Revenue and CMS Audits

Under-Coding vs Over-Coding is the single biggest coding decision that determines whether your facility keeps its revenue or hands it to CMS on a silver platter. Under-coding happens when a coder assigns a lower-level code than the documentation supports, which quietly erases revenue every single day. Over-coding happens when a coder bills a higher-level code than the […]

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