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Billing

Billing

Insurance claim denials

How to Fight Insurance Claim Denials and Turn Healthcare Laws Into Revenue

If your practice is dealing with more insurance claim denials than ever, you’re not imagining it. In 2026, payer denial rates remain high and inconsistent, with some insurers denying more than half of submitted claims while others deny very few. This lack of consistency creates major cash-flow issues, forces your staff into constant rework, and […]
Published Date: February 19, 2026
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Florida patient refund law 2026

How to Comply with Florida’s 2026 Patient Refund Law

Florida’s Patient Refund Law takes effect January 1, 2026, and it directly affects how your practice handles patient overpayments. If you collect more than a patient owes—even unintentionally—you are now on a strict clock to identify, process, and return those funds. This law is not just about awareness. It requires clear workflows, trained staff, documented […]
Published Date: February 10, 2026
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Evaluation and Management

What Your Practice Must Do Now to Get Paid for 99470, 99445, and RPM Services

The 2026 CPT code changes are no longer theoretical—they took effect January 1, 2026, and Medicare is already paying (or denying) claims based on them. If your billing team hasn’t updated workflows, documentation habits, and coding logic, your practice is likely missing reimbursement or triggering denials. These changes directly affect how Medicare recognizes physician time, […]
Published Date: January 28, 2026
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opt out of Medicare billing

Opting Out of Medicare Billing: What Your Practice Needs to Know (Before You Do It)

Opting out of Medicare billing isn’t just a physician decision—it’s a practice-wide operational shift that affects scheduling, billing workflows, patient communication, contracts, and revenue strategy. Front-desk staff, billers, managers, and compliance teams all play a role in getting this right. If your practice is struggling with low reimbursement, rising administrative burden, or constant Medicare rule […]
Published Date: January 22, 2026
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cms complaint form

Using the New CMS Complaint Form: What Medical Practice Staff Need to Know (and When to Use It)

If you work in a medical practice, you already know this truth: Medicare Advantage plans create more problems than they solve. Delays, denials, confusing requirements, and poor communication don’t just frustrate patients — they slow down your workflow, increase claim denials, and hurt the revenue cycle. Over time, these repeated issues drain staff time and […]
Published Date: January 15, 2026
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claim denials

Guaranteed Ways to Slash Claim Denials and Strengthen Your Revenue Cycle

If your practice is dealing with frequent claim denials, you’re not alone. Denials slow cash flow, increase staff workload, and create frustration across your entire revenue cycle. Over time, high denial volumes can quietly drain thousands of dollars from your practice and overwhelm your billing team. Every denied claim means delayed payment, extra staff time, […]
Published Date: January 13, 2026
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How to Prevent the 3 Most Common Medical Claim Denials

Every practice works hard to appeal claim denials and overturn them to get back the reimbursement they’re due. But what if you could spend less time on appeals by preventing medical claim denials before they happen? In some cases, you probably can. Check out three strategies to halt medical claim denials so you can collect […]
Published Date: December 29, 2025
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Conversion factor

How to Navigate Two Conversion Factor Options in 2026

When CMS released the 2026 Fee Schedule Final Rule in November, medical practices were surprised to see that it included not one conversion factor, but two. Read on to discover how to determine which conversion factor will apply to you. Most Practices Will See a Conversion Factor of $33.40 The majority of medical practices will […]
Published Date: December 18, 2025
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Aetna Softens New Medicare Advantage Downcoding Policy

Another day, another downcoding policy to grapple with. And while that’s unfortunately the reality in today’s healthcare world, the latest news from Aetna isn’t all bad. The payer has issued a new downcoding policy, but swiftly relaxed it and pushed back the implementation date. Check out the essentials you must know to prepare for Aetna’s […]
Published Date: November 26, 2025
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