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Billing

Billing

2026 CMS fee schedule

2026 CMS Final Rule Debuts 2 Separate Conversion Factors

The 2026 CMS final rule was issued on October 31, despite the fact that many people wondered whether the government shutdown would delay it. Key among the changes to the 2026 Medicare Physician Fee Schedule Final Rule is a big adjustment to how the conversion factor is applied to your claims. Check out a few […]
Published Date: November 11, 2025
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Medicare Flex Card

3 Things Patients Can Pay for With a Medicare Flex Card

If you see Medicare Advantage beneficiaries, you’ve probably been asked about a Medicare Flex Card before. This is a preloaded debit card that some Advantage plans issue to patients so they can pay for certain expenses to help them stay healthy. While every plan is different, there are some commonalities regarding which services may be […]
Published Date: November 10, 2025
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Outlier

How to Respond if Your Payer Says You’re an ‘Outlier’

Has your practice ever gotten notified that you’re an outlier? If so, you may realize the fear this can create, and the possibility that you may end up getting audited or seeing your claims downcoded. Not every outlier letter means you’ll face lost revenue, but it can still be upsetting. Check out a few steps […]
Published Date: November 5, 2025
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Internal audit

5 Keys to Internal Audit Success at Your Medical Practice

An internal audit can help your practice identify any errors in your billing, coding or medical records, and can help you discover whether you’re violating any regulatory requirements. These audits can be prospective (where you review claims prior to submitting them) or retrospective (when you review claims that were paid). Whichever you choose, remember that […]
Published Date: October 28, 2025
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Medical recordkeeping

5 Medical Recordkeeping Do’s and 5 Don’ts to Stay Compliant

Experts believe that eight in every 10 medical bills contain errors, which means the majority of medical practices are setting themselves up for denials, as well as accusations of fraud, waste and abuse. The best way to avoid issues is to maintain accuracy in your coding, billing and medical recordkeeping practices. To stay on the […]
Published Date: October 15, 2025
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Telehealth

How the Gov’t Shutdown Impacts Telehealth, Payment Timeliness

As most practices are aware, the government didn’t pass a funding bill by the time the October 1, 2025 deadline arrived. And while CMS will retain about half of its staff during the government shutdown, practices are still likely to see some big changes due to the shutdown — most significantly to telehealth and payment […]
Published Date: October 7, 2025
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Billing errors

5 Little-Known Billing Errors That Cost Your Practice Big Money

Your practice is likely aware of the most common billing errors that cost you money. These may include submitting the wrong claim form, undercoding your services and misusing modifiers. But your practice shouldn’t focus only on the most common billing issues when evaluating how you can bring in more cash. Check out five little-known billing […]
Published Date: September 30, 2025
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RAC audits

RACs Reveal 14 New Audit Targets After a Year of Silence

It’s been almost a year since the government released new RAC audit issues, but after all that silence, CMS recently issued 14 new targets. If you’d like to stay on the right side of the law, it’s important to know what the government is planning to audit so you can prepare. Check out just a […]
Published Date: September 9, 2025
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copay

Copay Collection Strategies to Keep Your Practice Thriving

Collecting copay amounts from your patients is a necessity if you want to maximize your income. You may think of it as $20 here or $30 there, and that’s true. Add them all up, however, and you’ve got tens of thousands of dollars a year coming in through copayments. Your best bet is to create […]
Published Date: August 19, 2025
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2026 Fee Schedule Proposal & Big Beautiful Bill: Impact on You

The 2026 CMS Fee Schedule proposal has been released, just on the heels of Congress’ approval of the Big Beautiful Bill. If your practice is wondering how these two regulatory documents impact you, you’re not alone. Check out five ways the 2026 CMS Fee Schedule proposal could impact your practice, along with takeaways on how […]
Published Date: July 30, 2025
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