Questions to Ask Before Hiring a Pain Management Billing Company

If you’re evaluating a pain management billing company, the short answer is this: ask how they handle WISeR prior authorization, urine drug testing (UDT) compliance, interventional procedure coding, and denial appeals before you sign anything. Pain management practices lose more revenue to prior authorization gaps and UDT audit exposure than almost any other specialty, and […]

How to Recover Unpaid Claims in Gastroenterology Billing

To recover unpaid claims in gastroenterology billing, segment aged AR by denial reason and procedure type, trace each claim back to its root cause, whether that’s a colonoscopy modifier error, an incomplete infusion prior authorization, or a bundling mistake, and correct the underlying workflow so the same claims stop recurring. That’s the core answer. Simply […]

Is Your OBGYN Billing Company Ready for CPT 2027?

No, most OBGYN billing companies are not yet ready for CPT 2027, because the January 1, 2027 shift from global obstetric codes to phase-based reporting demands new documentation habits, new claim logic, and new revenue cycle infrastructure that few vendors have actually built. Key Takeaways CPT 2027 deletes 17 global obstetric codes and replaces them […]

How to Reduce Neurology Claim Denials Without Increasing Administrative Work

The most effective way to reduce neurology claim denials without increasing administrative work is to improve documentation accuracy, strengthen coding processes, and verify insurance eligibility and prior authorizations before claims are submitted. A specialty-focused neurology billing workflow helps prevent errors upfront, reducing denials while improving reimbursements and minimizing staff workload. The right approach uses better […]

Is Your Family Practice Billing Company Ready for Medicare Advantage Growth?

No — your family practice billing company is not ready for Medicare Advantage growth if it is applying traditional Medicare billing logic to MA plans, managing prior authorization reactively, and reporting MA performance through a blended collections figure that conceals whether your practice is collecting what MA contracts require or absorbing what MA plans choose […]

GW Modifier in Medical Billing: Are You Applying It to the Right Claims?

The GW modifier in medical billing tells Medicare that a service given to a hospice patient has nothing to do with their terminal diagnosis, so the claim should be paid outside the hospice per diem. Get this modifier wrong, and Medicare either denies the claim outright or, worse, pays it and then recoups the money […]

Which Are the Best Cardiology Medical Billing Companies in 2026?

The best cardiology medical billing companies in 2026 share a specific set of traits: deep familiarity with cardiac CPT and modifier logic, MAC jurisdiction-specific LCD tracking, provider-level denial management, and a documented approach to old AR recovery, not just new claim submission. Rather than a fixed ranked list, since a good fit depends on a […]

What the Best ASC Billing Companies Measure Every Month

The best ASC billing companies measure ten metrics every month — and the difference between a billing company that measures these ten and one that delivers a collections summary is the difference between a surgery center that grows and one that collects without knowing whether it collected what it was owed. Most ASC billing companies […]

Why Are Payers Rejecting Your XU Modifier Claims in 2026?

Payers are rejecting XU modifier claims in 2026 mostly for three reasons: the documentation doesn’t clearly show the service was non-overlapping, the coding team defaulted to modifier 59 instead of the more specific XU modifier, or the code pair carries a Correct Coding Modifier Indicator of “0,” which means no modifier can bypass the edit […]

GW Modifier for Hospice: Unrelated Condition or Costly Compliance Gap?

The GW modifier for hospice tells Medicare that a service is clinically unrelated to a patient’s terminal illness, so it can be paid separately from the hospice per diem instead of being denied or bundled into hospice coverage. That one-line definition sounds simple. In practice, it sits at the center of one of the fastest-growing […]

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