-
@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…
-
@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…
-
@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…
-
@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…
-
@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…
-
@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…
-
@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.
-
@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.
-
@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.
-
@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.
-
@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.
-
@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.
-
@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.
-
@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.
-
@michealceditor·
Essential Strategies for Successful Contract Negotiation with Payors
This comprehensive guide provides detailed insights that will help physicians navigate the complexities of contract negotiation and ensure financial stability.
-
@michealceditor·
Chiropractic Billing: 5 Ways to Augment your Revenue
Medicare has many restrictions and commercial payors may have a lesser number. Documentation of medical necessity is critical to get claims paid.
-
@michealceditor·
Ambulance Billing: Best Practices to Maximize Revenue
Ambulance services are handled by paramedics and other medical professionals. They are well trained and equipped to carry out the first aid and transportation.
-
@michealceditor·
Why is Patient Demographics Crucial in Medical Billing?
The correctness and completeness of demographics data of patients assumes importance. Patient demographics entry is the basis of a claim.
-
@michealceditor·
Dermatology Coding: Avoid Common Errors And Increase Your Revenue
dermatology coders must be able to distinguish between simple, intermediate and complex repairs.
-
@michealceditor·
How can a superbill benefit your patient?
The superbill contains the list of services provided to a patient. Along with the list of services, the superbill will show the costs and codes for each exam, treatment, or procedure. It will also contain information about the patient, provider…
-
@michealceditor·
Clean-up Aging Accounts Receivable (AR) Using Onshore and Offshore Resources
Healthcare revenue cycle management is a complex process. Adding to the complexity is the fact that rules and regulations as well as codes keep changing regularly.
-
@michealceditor·
What is Healthcare Revenue Cycle Management?
RCM begins when a patient makes his/her appointment to visit a physician. And it ends when all payments due to the physician for services rendered are collected from payors and patients. The process from start to finish is rather complicated.
-
@michealceditor·
5 Podiatry Coding Mistakes that Impact your Cash Flow
Medicare and commercial payors insist on medical necessity for foot care and thus, coding in podiatry specialty and revenue cycle management (RCM) is an area where confusion reigns.
-
@michealceditor·
Effective Denial Management with Rigorously Tested Strategies
Medical professionals submit millions of claims every day to payors. Most claims are reimbursed fully by payors. As per the AMA reports, claims denied on the first submission amount to 1.38% to 5.07% of the total claims.
-
@michealceditor·
Want to Run RCM Operations Efficiently? Check out these Best Practices
A medical facility’s entire financial process is termed Healthcare Revenue Cycle Management (RCM) and it covers management and collection of revenue from healthcare service to patients.
