Outgrowing informal billing? Here’s how to think about revenue cycle roles, and the order in which growing practices should actually hire them.
A timely filing denial is often non-appealable, which makes prevention far more valuable than any downstream fix. Here’s how deadlines vary by payer, plan, state, and claim type.
From the January 2027 electronic prior-auth deadline to CMS’s WISeR model and expanding DMEPOS requirements, here are the concrete 2026 developments billing teams need on their radar.
Trauma, oral surgery, TMJ, sleep apnea appliances, and pre-treatment clearances are often medically necessary even though they start in a dental chair. Here’s how to document and bill them correctly.
In-network vs. out-of-network is often the single biggest factor in what you pay for care. Here’s what the terms really mean, and how balance billing still happens.
Most practices have a denial ‘process.’ Few have a workflow that actually gets followed every time. Here’s how to build triage, ownership, SLAs, and a feedback loop that stick.
AI now handles routine claims work in most billing departments. The real question is how to structure a team around that: who does what, and how to avoid over-trusting or under-trusting the tools.
Medical bills are full of confusing codes and numbers. Here’s a plain-language guide to what’s actually on your bill, and what to do if something looks wrong.
AI earns its place on high-volume, pattern-based work like scrubbing, eligibility, and drafting. Clinical judgment, payer negotiation, and compliance sign-off still need a human.
Clean claim rate is the earliest indicator in the billing pipeline. Here’s what it measures, why it predicts cash flow better than most other metrics, and how to improve it.