Is Your Practice Losing Revenue by Misclassifying Medical vs Routine Vision Billing?

Yes — misclassifying medical vs routine vision billing costs a 30-patient/day optometry practice between $200,000–$275,000 in lost annual collections. The chief complaint at presentation — not the patient’s insurance preference — determines whether an encounter is billed to medical insurance (reimbursing $120–$180) or a vision plan (reimbursing $45–$70). The revenue gap hiding inside most optometry […]

Could Your ASC Survive a CMS Audit Tomorrow?

No, most ASCs collecting $1M–$5M+ monthly could not survive a CMS audit tomorrow—because 68–78% of Ambulatory Surgical Centers fail unannounced CMS surveys on first attempt when deficiencies in implant tracking documentation, infection control protocols, emergency equipment maintenance logs, and surgical consent forms trigger immediate CMS-2567 deficiency citations requiring mandatory Plans of Correction, creating $1.2M–$3.8M in […]

What Does Week One of a Neurology Audit Reveal About Revenue?

Week one of a neurology audit reveals $1.2M–$3.8M in annual recoverable revenue when systematic analysis uncovers that 35–48% of EEG interpretations lack proper CPT modifier documentation creating bundling denials, 42–56% of EMG/NCS studies are undercoded by one complexity level losing $180–$340 per procedure, Botox administration billing captures only 62% of actual units injected due to […]

Are Your Interventional Pain Billing Guidelines Costing You Revenue?

The interventional pain billing guidelines 2026 require multi-physician pain groups and ASCs to immediately adapt to three compounding revenue threats: a CMS-finalized -2.5% efficiency adjustment on non-time-based procedure RVUs, mandatory prior authorization for Epidural Steroid Injections under the WISeR Model effective January 1, 2026, and a site-of-service payment differential that reduces facility-based indirect practice expense […]

What does a standard AR summary actually show?

A standard AR summary shows the total outstanding receivables organized by aging buckets (Current, 1–30 days, 31–60 days, 61–90 days, Over 90 days) revealing how much revenue remains uncollected and how long claims have been unpaid—with healthcare practices collecting $1M–$5M+ monthly losing $1.2M–$3.8M annually when AR aging reports show 18–28% of receivables in the Over […]

Are Implant Gaps the Source of Your ASC Revenue Leakage?

Yes — implant gaps are the primary source of ASC revenue leakage, with Ambulatory Surgical Centers collecting $1M–$5M per month losing $1.2M–$3.8M in 12-month revenue when 35–52% of implantable devices lack real-time charge capture documentation. The leakage compounds across three failure points: $8,500–$24,000 implant costs left unbilled per missed capture, invoice-to-claim reconciliation gaps leaving $180,000–$420,000 […]

Why Are Optometry Practices Missing Their Days in AR Benchmarks?

Optometry practices are missing their Days in AR Benchmarks because three compounding billing failures — vision-versus-medical plan misclassification, NCCI diagnostic bundling errors, and legacy ICD-10 coding after the October 2025 code update — are stalling claims in payer queues long after payment should have arrived. The national average sits at 35–40 Days in AR across […]

How Global Maternity Bundle Exceptions Are Costing OBGYN Practices $1.2M-$3.6M

Global Maternity Bundle Exceptions Costing OBGYN $1.2M–$3.6M

Global maternity bundle exceptions cost OBGYN practices collecting $1M-$5M per month between $100,000 and $300,000 in monthly revenue totaling $1.2M-$3.6M over 12 months because the four categories of services that fall outside the global obstetric package high-risk pregnancy complications, transfer-of-care scenarios, separately billable diagnostic procedures, and ancillary services excluded by payer-specific contract terms are systematically […]

Why Physician Groups Choose MBC: What a Revenue Integrity Partner Looks Like vs. a Billing Vendor?

How MBC as your Revenue Integrity Partner works for your Physicians Group / Physicians / Hospital / Practice. The difference isn’t just performance. It’s what your CFO gets to know — and act on — that changes the business. There’s a conversation happening in more CFO offices than most billing vendors would like to admit. […]

Why Are Prior Authorization Denials Spiking in Wound Care?

Prior Authorization Denials are spiking in wound care because 2026 has fundamentally changed the authorization landscape — the CMS WISeR Model launched January 1, 2026, introducing AI-driven prior authorization requirements for skin substitute applications in six pilot states, while simultaneously a new flat reimbursement rate of $127.14 per square centimeter for non-biological skin substitutes triggered […]

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