Billing & Collections

Rachel V. Rose, J.D., MBA, on the False Claims Act risk created when a biller assumes who rendered the care on a claim.

Prior authorization drains about 13 hours a week from the average practice, and these eight fixes win that staff time back.

A temporary 2026 raise, a new efficiency adjustment and a stalled fix in Congress are squeezing practice pay heading into 2027.

The costliest billing misses never trigger a denial, and these six EHR fixes recover revenue your documentation already supports.

Medicare Advantage drives more denials than any other payer, and these six moves help your practice push back and get paid.

MGMA’s Anders Gilberg breaks down the new No Surprises Act IDR rule, from the $15 fee to what it means for practices.

Community Health Integration codes let practices bill Medicare for addressing patients' social needs. Most eligible practices aren't using them.

Sort the work before hiring: Kem Tolliver and Taya Gordon share a revenue cycle playbook for stressed practices.

Revenue cycle leaders at the 2026 MGMA Summit laid out the digital patient billing playbook and the order of operations administrators should follow.

Downcoding, underpayments, missed incident-to: eight revenue cycle leaks to catch before they drain you.

The series returns with Lucien Roberts and Bert Wilson on allowables, collection percentages and what a practice actually collects.

Patients are increasingly primary payers. Nine front-end moves to keep balances from sliding into bad debt.

Denial rates are climbing past 10% at many practices. Here are six places to recover revenue without overhauling billing.

A nurse-led framework for when independent practices should bill CHI, PIN or CCM for Medicare care coordination work.

Eight practical ways to plug revenue leaks, from eligibility checks and point-of-service collections to working denials by root cause.

A new AMA survey scores the country's largest commercial insurers on the prior authorization burden they impose on physician practices.

As high-deductible plans shift more costs to patients, practices need stronger front-desk collection workflows before balances become write-offs.

Two years after a historic health care cyberattack exposed dangerous single-point failures in claims routing, the industry has largely rebuilt the same vulnerable structure.

From clean claim rates to contract negotiations, these warning signs could mean your practice is leaving thousands in revenue uncollected.

From missed submission windows to overlooked bonuses, here is what MIPS participants need to review now to protect their Medicare payments.

Tell us about your practice's finances: Physicians Practice wants to know how your practice is holding up. Take our quick survey.

Revenue cycle consultant Kem Tolliver says practices that bring frustration instead of data to payer disputes will keep losing ground.

Small practices may be missing thousands of dollars in Medicare revenue monthly. Here are 6 billing opportunities that don't require new patients or more hours.

Independent practices can win payer negotiations, but preparation is everything. Doral Jacobsen of Prosper Beyond VBC explains how.

Denials are up, margins are down and patients owe more than ever. This is what physician practices need to know to protect their revenue cycle in 2026.