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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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Understanding the FY 2026 ICD-10-CM Guidelines: Why Auditing Matters More Than Ever
The FY 2026 ICD-10-CM Official Guidelines for Coding and Reporting are now in effect for encounters on or after October 1, 2025, and they bring significant updates. With 487 new codes, 38 revisions, and 28 deletions, alongside fresh guidance for conditions like HIV,...
Why Coding and Auditing Compliance Are Essential to Revenue Cycle Success
In healthcare, compliance is not optional, it’s a necessity. While most organizations understand the importance of protecting patient data and meeting regulatory standards, many overlook how critical coding and auditing compliance are to the overall health of the...
How Smart Scheduling Impacts Your Bottom Line
In healthcare, efficiency is everything. From managing patient flow to optimizing provider time, the way a practice handles scheduling directly impacts both the patient experience and the organization’s financial health. Smart scheduling, leveraging best practices and...
The Hidden Costs of Revenue Cycle Inefficiency
In healthcare, revenue cycle management (RCM) is more than just billing and collections, it’s the backbone of financial stability. Yet too often, inefficiencies within the revenue cycle quietly drain resources, delay payments, and put unnecessary stress on both...
The Credentialing Process from Start to Finish
In the world of healthcare, provider credentialing is a crucial yet often overlooked process. Whether you’re onboarding a new physician or managing a growing provider network, understanding the credentialing process from start to finish ensures compliance, speeds up...
Unlocking Your Coding Power: Why Quality Courses Matter
In today’s fast-paced healthcare landscape, medical coding is more than just data entry, it’s the backbone of accurate billing, revenue integrity, and regulatory compliance. Yet, many professionals overlook how transformative a high-quality medical coding course can...
Navigating Medical Accounts Receivable with HIPAA Compliance in Mind
In the complex world of healthcare finance, managing medical accounts receivable (AR) is more than just a numbers game, it’s a balancing act between financial performance and patient privacy. AR refers to the outstanding payments owed by patients or insurance...
FY2026 ICD-10-CM Updates Are Out! What You Need to Know Before October 1, 2025.
The FY2026 ICD-10-CM code updates have officially been released, bringing substantial changes that every medical coder, provider, and healthcare organization should begin preparing for before the October 1, 2025, effective date. These updates are designed to reflect...
Common RCM Bottlenecks and How to Eliminate Them with Workflow Automation
Revenue Cycle Management (RCM) is the lifeblood of any healthcare organization, bridging the gap between patient care and financial stability. Yet, for many practices, RCM bottlenecks in the workflow frequently result in delayed payments, high denial rates, and...
Credentialing Across Payors: Navigating Private vs. Medicare Timelines
Navigating the credentialing process in healthcare can often feel like a labyrinth, especially when comparing Medicare’s structured timeline with the variability of private payors. For providers and administrators managing multiple contracts, this challenge isn’t just...