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 […]
E/M level misassignment risk is the probability that a physician practice is systematically billing evaluation and management encounters at incorrect code levels — either undercoding due to documentation caution or overcoding due to template-driven charting — resulting in $60,000–$220,000 in annual revenue loss or audit liability. According to MBC’s 2026 revenue cycle management services analysis, […]
Yes — Algorithmic Downcoding is silently stripping $12,000 to $30,000 per orthopedic surgeon annually, and most practices don’t see it happening until the damage is already done. If your case volume is steady but your reimbursements keep shrinking, the culprit isn’t your coding team. It’s a software system your payer built specifically to reduce what […]
Algorithmic downcoding by Medicare Advantage occurs when MA plans use automated software to systematically reduce physician-submitted E/M codes — typically from 99214 or 99215 to 99213 — without clinical review, costing the average multi-specialty practice $40,000–$180,000 annually in suppressed reimbursement. According to MBC’s 2026 RCM services analysis, 68% of MA downcoded claims are recoverable through […]
Yes — Medicare Advantage downcoding is quietly draining wound care revenue, and most practices don’t even see it happening until six figures are already gone. Here’s the reality: wound care is one of the highest-risk specialties for algorithmic claim suppression. Your patients are sicker. Your procedures are more complex. And that exact complexity is what […]
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