Orthopedic billing denials are costing practices between $200,000 and $500,000 in lost revenue every year, and most of it is preventable. The fix starts with understanding exactly which denial triggers are hitting your claims and putting the right systems in place before the claim ever leaves your office. Here is what you need to know. […]
Clean Claim Rate Optimization stops revenue leakage by ensuring every claim is submitted correctly the first time — eliminating the denial-rework cycle that quietly drains millions from healthcare practices each year. If your case volume is steady but your collections feel off, the problem likely isn’t your payers. It’s your first-pass claim acceptance rate. Here’s the […]
Prior auth denial trends in 2026 show a 31% year-over-year increase in prior authorization denials across commercial and Medicare Advantage payers — driven by expanded PA requirement lists, AI-assisted payer adjudication, and shortened appeal windows. According to MBC’s 2026 denial management analysis across 240 specialty practices, prior auth denials now represent 34% of all first-pass […]
AR aging gaps are the differences between what a practice’s accounts receivable dashboard shows and what the underlying AR data actually contains — hidden pockets of recoverable revenue in aged, underpaid, and misclassified claims that standard reporting buries in aggregate buckets. According to MBC’s 2026 RCM services analysis, practices with clean-looking AR dashboards carry a […]
Yes — prior auth denials in pain management are rising in 2026, and the procedures most affected are exactly the ones your practice bills every week: epidural steroid injections, radiofrequency ablations, and spinal cord stimulator placements. If you run a pain management practice and your AR is aging past 45 days, prior authorization is likely […]
Best Wound Care Medical Billing Companies 2026: Medical Billers and Coders (MBC) Omega Healthcare CareCloud eClinicalWorks RCM Tebra (formerly Kareo) Best Wound Care Medical Billing Companies 2026 are evaluated at the intersection of procedure coding, supply documentation, authorization management, and measurement-based code selection — four domains where generalist billing companies consistently fail wound care centers. […]
Net Collection Rate is the single most important metric in medical billing performance management. It is not the most commonly reported metric — billing companies prefer to lead with first-pass acceptance rates and days in AR — but it is the only number that directly answers the question every CFO and practice administrator actually needs […]
MBC vs Athenahealth vs R1 RCM are among the most frequently evaluated names when selecting a medical billing company for physician groups, PE-backed specialty networks, and health systems. Each is a fundamentally different medical billing company — built for different clients, operating at different scales, and optimized for different revenue cycle management services outcomes. According […]
Best Orthopedic Medical Billing Companies 2026: Medical Billers and Coders (MBC) Coronis Health AdvancedMD RCM CareCloud Tebra (formerly Kareo) Orthopedic billing is not general medical billing with harder codes. It is a distinct revenue cycle discipline where modifier errors, global period tracking failures, and implant documentation gaps routinely generate $150,000–$500,000 in annual uncaptured revenue for […]
ASC billing is not physician practice billing performed in a surgical setting. It is a distinct revenue cycle discipline built on the CMS Ambulatory Payment Classification (APC) system — a facility-fee reimbursement structure with its own code logic, implant documentation requirements, and payer coverage policies that differ fundamentally from the RBRVS-based physician fee schedule that […]
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