News

Taya Gordon says education, appeals and payment alerts top the to-do list before Medicare's 2027 same-day and G2211 changes hit Jan. 1.

Practices face a lower conversion factor and new billing rules on Jan. 1, while group visits, coaching and ACO options open other revenue paths, according to group reaction.

CMS’ latest rule will have practice-level effects next year. Here’s what to know to get ready.

Revenue cycle consultant Taya Gordon explains what practice administrators and billing teams should do this week to prepare for Medicare's final 2027 fee schedule, from the same-day visit cut to the switch from G2211 to modifier B1.

Office 2021 and Windows 11 24H2 lost security fixes Oct. 13, and Windows Server 2016 is next. Here's where outdated tech hides in a practice.

The Fifth Circuit revived a Meta Pixel class action against Eyemart, finding IIHI covers far more than prescription data. Here's why it matters.

Pear Suite CEO Colby Takeda explains how practices can partner with community health workers to help patients keep Medicaid coverage as work requirements take effect Jan. 1.

Practices face a 2.31% conversion factor cut, a 20% same-day visit reduction and new E/M modifiers starting Jan. 1.

Two Medicare fraud cases, one over Botox and one over COVID-19 test kits, map the chart and claims gaps practices should audit now.

Keli Beeson of Coronis Health covers where Kentucky Medicaid behavioral health claims break down across five MCOs and how to keep them paying.

Eduardo Porras of Medusind shows how to tell timing gaps, unapplied cash and true underpayments apart, and how to recover what payers still owe.

Survey data from 1,300 physicians and administrators show where workload pressure hits hardest and how practices can put existing visit time to work.

Doral Jacobsen, MBA, FACMPE, shares case studies, targeted questions and the communication tactics behind stronger payer contract negotiations.

The federal checklist behind your EHR shrinks Dec. 28. Lock down your contract, MIPS reporting and referral workflows while you have leverage.

Medicare’s monthly bundled codes pay primary care for work between visits. Most practices have not tried them yet.

'Not covered' is now the top denial reason, and UnitedHealthcare's pediatric code lists don't match. Run these checks before Dec. 1.

The 2026-2027 respiratory season is just about here. There’s still time to vaccinate patients, experts say.

The 2nd and 5th circuits won't let providers sue over unpaid IDR awards. Here are the routes left and how to reserve for money that may never come.

WISeR cut targeted services 15 to 20 percent in six states. These fixes protect your volume, your claims and your patients' place in line.

Two Mayo Clinic preventive cardiologists share how practices can make home blood pressure data, simple patient goals and short visits work for heart disease prevention.

Neil Baum, MD, offers physicians a simple ethics check: Could you comfortably explain your decision to a patient or colleague over coffee?

Premiums are climbing far faster than physician pay. Here's how independent practices can build the case for higher payer reimbursement rates.

Insurer exits and network splits will change Medicare Advantage coverage for many patients on Jan. 1. Here's how practice leaders can prepare in every state.

Pennsylvania's outbreak is part of a national surge. Here's how to prepare the front desk, exam rooms, staff records and vaccine supply.

A Johns Hopkins employee put 3,182 patients' data into a consumer AI tool. Here's what that mistake would cost a small practice.

Four health policy experts preview the proposed 2027 Medicare physician fee schedule and what the same-day visit cut, prior authorization and alternative payment models mean for practices.

Hurricane Isaias waivers add little on telehealth, but Medicare Advantage network rules and refill limits loosen for Florida practices.

Most partnership problems are predictable. Settle pay, governance, new partners and succession while the group is healthy, not after trouble starts.