Billing & Collections

A rate bump means nothing if the fine print lets a payer claw it back. Six traps to catch before you sign or renew.

Most staff touches to get claims paid never produce revenue, MedEvolve CEO Matt Seefeld says, and the wasted work is crushing practice margins.

It's the week of the Fourth of July. Here are 10 ways AI and automation can free your revenue cycle from the manual grind behind every denied claim.

Indiana limits AI downcoding of physician claims July 1, and more states are moving to rein in payers.

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.

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