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Healthcare Revenue Cycle Management
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Percentage-Based Medical Billing: Why It’s a Compliance Trap for Medicare, Medicaid, and Many Commercial Plans
Percentage-based billing (charging a percent of collections or revenue) can be prohibited for Medicare and Medicaid payment arrangements and can violate state fee-splitting rules for commercial claims. Learn what’s risky, what’s illegal in certain contexts, and how to...
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Managing a Remote Revenue Cycle Management Team: Best Practices for Productivity, Compliance, and Performance
Remote work has become the new normal across the healthcare revenue cycle industry. Coding, billing, A/R follow-up, prior authorization, and patient financial services roles are increasingly being performed from home—and practices that embrace remote workforce models...
CPT Updates and EMR/PMS Implementation: Why Practices Must Align Technology With Coding Accuracy
Every year, the American Medical Association (AMA) releases updates to the CPT code set—additions, revisions, deletions, and guideline adjustments that directly impact reimbursement, compliance, and clinical documentation standards. At the same time, many practices...
Start 2026 Strong: Essential CPT Changes Every Practice Must Prepare For
The 2026 CPT® code updates introduce some of the most sweeping revisions in years. These changes impact core service lines—including interventional radiology, audiology, digital health, and remote patient monitoring—and will directly influence reimbursement,...
Why Compliance Should Be Part of Every Staff Meeting (Culture Focus)
Compliance should never be a once-a-year box to check. It needs to be woven into the daily culture of every practice. One of the most effective ways to do this is by including compliance topics in every staff meeting. Reinforcing Responsibility When compliance is part...
How Smart Scheduling Impacts Your Bottom Line (Patient Flow Focus)
In healthcare, time is money. Every unused appointment slot represents lost revenue, while overbooking creates chaos. Smart scheduling strategies maximize provider time, improve patient flow, and protect the bottom line. Reducing No-Shows Missed appointments drain...
Why Real-Time Eligibility Verification Matters
Eligibility errors are one of the most preventable causes of claim denials, yet many practices still rely on manual processes. Real-time eligibility verification provides immediate confirmation of patient coverage, reducing denials and improving patient experience....
The Credentialing Process from Start to Finish (Pain Points & Solutions)
Credentialing is one of the most time-consuming yet critical steps in practice management. Without it, providers cannot bill insurers or treat patients under payer contracts. The credentialing process often takes 90–120 days, and missteps can extend that timeline...
Why Staying Current on Medical Coding Updates Is Essential for Every Healthcare Practice
In the fast-moving world of healthcare, medical coding isn’t static — it evolves every year with new, revised, and deleted codes that reflect medical innovation, changing payer rules, and updated clinical guidelines. For providers, billers, and coders, staying current...
The Compliance-First Approach to Reducing Aging A/R in Medical Practices
Few challenges frustrate healthcare practices more than aging accounts receivable (A/R). As balances age, the likelihood of collection drops sharply. However, rushing to recover payments without a compliance-first mindset creates bigger risks—patient dissatisfaction,...
Why Outsourcing Medical Coding Makes Sense for Today’s Healthcare Practices
Accurate medical coding is the foundation of every successful revenue cycle. But for many practices — especially small and mid-sized ones — managing in-house coders can be expensive, time-consuming, and difficult to scale. That’s why more providers are turning to...