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STOP Credentialing Delays from HOLDING UP YOUR REVENUE Learn More

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All Blogs

2021 EM Coding Changes

6 Ways to Improve Medical Coding and Billing Accuracy and Protect Your Revenue

Strong documentation is only half the battle when it comes to getting your practice paid correctly. Your codes must accurately reflect what the provider documented and the services your practice actually performed. Get the coding wrong in either direction, and your practice can pay for it. Upcoding can trigger payer scrutiny, audits, repayment demands and […]
Claims hold

The Hidden Compliance Risks of AI Medical Documentation

Artificial intelligence is changing the way medical practices document patient care. AI-powered scribes and documentation tools can help reduce physician burnout, speed up charting, and improve workflow efficiency. But if your practice focuses only on saving time, you could expose yourself to serious compliance, billing, HIPAA, and malpractice risks. Today, successful medical practices are shifting […]
CAQH ProView

CAQH Credentialing Checklist: 8 Steps to Avoid Payment Delays

An incomplete provider profile can create much bigger problems than another item on your administrative to-do list. When information used for credentialing is outdated, missing, or inconsistent, your staff may spend valuable time tracking down documents, responding to payer requests, and troubleshooting enrollment problems. Now that CAQH has become DataSpring, powered by CAQH, it’s a […]
Turn Denials to Revenue

Turn Medical Claim Denials Into Recovered Revenue

A denied claim doesn’t automatically mean lost revenue. But the longer your staff waits to address it — or the more time they spend working denials with little chance of recovery — the more expensive the problem becomes. Effective medical claim denial management requires more than working a queue from oldest to newest. You need […]
Professionalism

9 Ways to Improve Professionalism in Your Medical Practice

Professionalism in healthcare isn’t simply about how your employees dress, whether they arrive on time, or how politely they answer the phone. It shows up in how your team communicates when the office is overwhelmed, handles disagreements, responds to patients, accepts feedback, takes responsibility for mistakes, and works together when something goes wrong. Those everyday […]
patient collections best practices

How to Send a Patient Bill to Collections Without Creating Compliance Problems

Unpaid patient balances can put real pressure on your medical practice. But sending an overdue medical bill to collections shouldn’t be an automatic next step. Before you turn over an account, confirm that the balance is accurate, your practice has followed applicable billing requirements, the patient has received required notices, and the collection agency will […]

Internal CMS Audits: Find Your Medicare Compliance Risks Before an Auditor Does

Waiting until you receive an audit request to find out whether your Medicare documentation and billing processes will hold up is a risky strategy. CMS has significantly expanded its Medicare Advantage audit efforts, increased the use of technology to identify unsupported diagnoses, and dramatically expanded the number of medical coders reviewing records. At the same […]

Your CPT Data Could Be the Key to Higher Payer Reimbursement

When you ask a payer for a rate increase, are you asking for “more” — or can you show exactly where your reimbursement is falling short? That distinction matters. A general request for higher reimbursement gives the payer plenty of room to say no. A request supported by specific CPT codes, utilization, reimbursement comparisons and […]
Medicaid audit

How Medical Billing Training Can Improve Your Revenue Cycle

When claims are denied, delayed, or returned for corrections, your practice doesn’t just have a billing problem. You have money sitting outside your bank account. That’s why medical billing training should be viewed as part of your revenue cycle strategy—not simply another employee requirement. When your billing and coding staff understand current rules, recognize common […]
Provider Relief Fund

Fix Credentialing Denials Before They Become Write-Offs

When a claim is denied because of a provider enrollment or credentialing issue, simply correcting and resubmitting the claim may not solve the underlying problem. Your staff first needs to determine why the payer rejected the claim and whether the problem involves provider data, enrollment status, effective dates, participation or another issue. Without that investigation, […]