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@michealceditor·Beyond Appeals: The Shift from Denial Management to Denial Intelligence
Many healthcare organizations struggle with high denial rates despite extensive management efforts. This article explores how transitioning from traditional denial management to denial intelligence can revolutionize revenue cycle performance and…
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@michealceditor·
ASCs Have the Advantage. Why Are So Many Still Negotiating from a Position of…
ASCs have a proven cost and quality advantage, yet many continue to negotiate from a position of weakness. Discover five overlooked opportunities that can help surgery centers strengthen payer relationships, improve reimbursement performance, and…
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@michealceditor·
Mastering the Art of Clean Claims: Your Blueprint for Revenue Cycle Success
In today's healthcare environment, denials are climbing at an alarming rate. According to recent studies, providers saw a 60% increase in claim denials in 2024 compared to the previous year. For RCM leaders, this underscores the urgent need to…
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@michealceditor·
Head and Neck Angiography Coding in Interventional Radiology: Key Tips for 2025
With 2025 well underway, now is the perfect time to sharpen your knowledge of cervicocerebral angiography coding. This article takes a deep dive into CPT® codes 36221–36224 and the common pitfalls associated with them—ensuring you stay ahead of…
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@michealceditor·Billing and EHR Software Expertise | BHS | Software
Our expertise in over 40+ Billing and EHR software ensures hassle-free workflow integration and maximized accuracy. Learn more.
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@michealceditor·
CPT 2027 Maternity Care Coding Overhaul: Why the End of the Traditional Global…
The biggest change to maternity care coding in decades is on the horizon. Beginning January 1, 2027, CPT will replace the traditional global maternity package with a more detailed, phase-based reporting framework that reflects modern obstetric care…
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@michealceditor·
Beyond G2025: How RHCs and FQHCs Must Prepare for the Next Phase of Telehealth…
A major telehealth billing change is on the horizon for RHCs and FQHCs. With CMS phasing out G2025 and requiring service-level telehealth coding beginning October 2026, healthcare organizations must prepare for new reporting requirements, modifier…
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@michealceditor·
Beyond Code Updates: What the FY 2027 ICD-10-PCS Changes Mean for Hospitals…
More than just new codes, the FY 2027 ICD-10-PCS update signals where inpatient care and procedural reporting are headed next. Learn how hospitals and coding teams can prepare for emerging technologies, increased specificity requirements, and…
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@michealceditor·
Beyond Compliance: The Medical Billing Audit Checklist Every Practice Needs in…
Most revenue cycle problems aren't just about compliance; they stem from deeper issues. This article provides a medical billing audit checklist for 2026, helping practices move beyond basic compliance to proactively identify and address underlying…
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@michealceditor·
Beyond Denials: How Payer AI Is Redefining Revenue Cycle Risk
Payer AI is transforming how claims are reviewed, denied, and reimbursed. Discover why traditional denial management strategies are falling behind—and what providers must do to protect revenue in an increasingly automated payer environment.
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@michealceditor·
Finding Risks Before They Find You: A Modern Approach to Effective Monitoring
What if your organization could identify tomorrow's risks today? This article outlines a modern approach to effective monitoring, enabling businesses to proactively detect and mitigate potential threats before they impact operations or financial…
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@michealceditor·Exemplary Ethical Standards | BHS | Compliance
Through our continuous monitoring and compliance with federal regulations, we maintain absolute privacy, security, and integrity at all times. Learn more.
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@michealceditor·Intuitive Workflow Management | BHS | BristolByte
Intelligently track and monitor your entire administrative process including all sub-processes, workflows, and work assignments. Learn how.
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@michealceditor·
Revenue Integrity in the Value-Based Era: Safeguarding the Financial Health of…
As healthcare continues to evolve from a volume-driven system to one centered around value, patient outcomes, and cost-efficiency, the concept of revenue integrity has taken on a new level of urgency. No longer just a back-office concern, revenue…
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@michealceditor·
Clinical Language vs. Coding Language: Why Documentation Precision Defines…
In the data-driven healthcare landscape, accurate documentation is crucial for reimbursement and quality ratings. The disconnect between clinical language used by providers and coding language poses a significant operational threat, especially as…
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@michealceditor·
Telehealth Coding in 2025: Navigating the Complexities of Audio-Only Visits
In 2025, healthcare organizations must pay close attention to how audio-only services are documented and coded. From nuanced place of service reporting to payor-specific variations in coverage, the risks are high—and so are the consequences of…
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@michealceditor·
Is Your EHR Helping or Hurting? Signs It’s Time to Reassess Your System
In 2025, medical practices are expected to operate with greater agility, data-driven insights, and patient-centered workflows. If your current EHR is more of a burden than a benefit, it’s time to re-evaluate whether it still aligns with your…
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@michealceditor·
CMS Halts Eight MIPS Improvement Activities for 2025: What Providers Need to…
This decision, rooted in the Improvement Activities Suspension Policy finalized in the CY 2021 Physician Fee Schedule Final Rule, signals a possible shift in CMS’s long-term priorities for clinician performance evaluation.
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@michealceditor·
Inside the RUC Time Study: Understanding How Physician Work Is Valued—and Why…
For billing professionals, coders, and compliance leaders, this isn’t just a policy issue—it’s a practical one with real consequences in documentation, audits, and reimbursement integrity.
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@michealceditor·
Rethinking Risk Coding in 2025: Why Commercial Plans Are Redefining the HIM…
Risk-adjusted payment is no longer just a Medicare Advantage concern—commercial insurers are reshaping how coding, documentation, and compliance strategies must evolve.
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@michealceditor·
Hidden Losses: A Practical Guide to Uncovering Revenue Leakage in Your Medical…
From coding and billing errors to practice management missteps, we explore the root causes of revenue leakage and provide practical tools to protect your revenue.
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@michealceditor·
ICD-10-CM FY 2026 Code Updates: What Coders Need to Know Before October 1, 2025
Effective for discharges and encounters from October 1, 2025, through September 30, 2026, this release introduces 487 new diagnosis codes, 38 code revisions, and 28 code deletions.
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@michealceditor·
2025 CPT® Telemedicine Coding Overhaul: What You Need to Know
These updates aim to streamline the reporting of evaluation and management (E/M) services delivered via telehealth—whether through synchronous audio-video or audio-only communication.
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@michealceditor·
Mastering E/M Coding: How to Safeguard Your Revenue and Stay Audit-Ready
Documentation errors, whether undercoding or overcoding, can make you a target for payers who are becoming more proactive in spotting inconsistencies and recouping payments. A single bad audit can lead to more extensive investigations.
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@michealceditor·
Case Study: Optimizing Accounts Receivable for a Leading Ambulatory Surgical…
In this case study, we explore how a leading Ambulatory Surgical Center enhanced its accounts receivable management and reduced outstanding balances by implementing robust revenue cycle strategies.
