Ophthalmology billing is complex because it runs on two coding systems at once (Eye codes and E/M codes), stacks a 92-day global surgical period on top of one of Medicare’s highest-volume procedures, and demands drug-level accuracy for injectable medications that cost more per dose than a typical office visit. A federal watchdog just flagged $124 […]
Graft application billing has not kept pace with the CTP rule change for most wound care groups, and the gap shows up as underpayment on every claim still coded and documented the old way. CMS restructured how cellular and tissue-based products (CTPs) are paid under the CY 2026 Physician Fee Schedule Final Rule, moving most […]
AI in Revenue Cycle Management is not a magic fix that replaces your billing team overnight — it is a governed, data-driven layer that predicts denials, automates prior authorizations, and protects margins when it is implemented correctly. That single distinction separates the organizations seeing real returns from the ones stuck paying for software nobody trusts. […]
A strong Wound Care Revenue Cycle Model is the system a clinic uses to turn patient care into paid claims, covering everything from insurance verification and coding to denial appeals and collections. In 2026, this system matters more than ever because Medicare has rewritten the rules for how skin substitutes, debridement, and hyperbaric therapy get […]
AR Cleanup for Optometry Practices almost always starts in the same place: a stack of claims that were billed to the wrong plan on day one. An optometry visit isn’t automatically a “vision” claim or a “medical” claim. It’s whichever one the diagnosis and documentation say it is, and when front-desk staff or an EHR […]
Practices reduce Days in AR through root-cause denial analysis by tracing every denial back to the specific trigger that caused it, such as an eligibility gap, a coding mismatch, or a missing prior authorization, and correcting that trigger before the next claim goes out. This is fundamentally different from simply reworking a denied claim and […]
Yes — Cardiology Billing CPT Codes 2026 are directly causing claim denials right now, and if your practice has not restructured its billing logic, you are losing real money on every affected claim. The AMA made sweeping structural changes this year — not minor tweaks — including the deletion of an entire revascularization code series […]
CPT 66982 vs 66984 is not just a coding distinction — it is an audit trigger hiding inside your ophthalmology claims. When your complex cataract surgery ratio crosses 25% of total cataract cases billed, payers and Medicare Administrative Contractors flag your practice for immediate review. That single threshold is costing ophthalmology practices revenue on both […]
Automated Claims Processing is the answer to one of healthcare’s most persistent revenue problems: claims that leave your system clean but return as denials, write-offs, and wasted staff hours. In 2026, AI-powered billing infrastructure has made it possible to catch errors before submission, not after — reducing denial rates by up to 42% and cutting […]
The single most effective Claims Processing Best Practices strategy in 2026 is catching errors before a claim ever leaves your system. Practices that shift from reactive denial management to pre-submission validation are cutting rejection rates by up to 35% and collecting faster — without adding billing staff. Here’s what’s actually working on the ground. Why […]
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