Deep dive into expert analysis on Medical Billing, Revenue Cycle Management, and complex Healthcare Compliance topics.
Prior authorization is the biggest administrative hurdle. Learn our 3-step strategy to automate the process, drastically cutting approval times and reducing staff burnout.
Demeta Team • Nov 1, 2025
The Office for Civil Rights (OCR) is tightening enforcement. We detail the mandatory breach reporting deadlines and the required forensic documentation to keep your organization compliant.
By Compliance Expert on Oct 28, 2025
Incorrect application of Modifier 25 is a top cause of claim denial. We break down the clinical documentation requirements for billing an E/M service with a procedure on the same day.
By Certified Coder on Oct 20, 2025
Fee-for-service is dying. We explore the financial models—APMs, ACOs, and Bundled Payments—that practices must adopt to ensure sustainable revenue in the new healthcare economy.
By Industry Analyst on Oct 15, 2025
Identify your weak points. We detail the seven key performance indicators auditors focus on, including Clean Claim Rate, Denial Rate, and Days in Accounts Receivable.
By Data Scientist on Oct 1, 2025
Your EHR is more than a note-taking tool. Learn how to optimize templates, leverage smart documentation, and ensure clinical data seamlessly translates into accurate billing codes.
By EHR Consultant on Sep 25, 2025
The No Surprises Act requires new protocols for billing. We detail who needs a Good Faith Estimate (GFE), when it must be provided, and the penalties for non-compliance.
By Regulatory Advisor on Sep 18, 2025
Telehealth remains critical, but billing rules are constantly changing. We outline the latest Place of Service codes and the appropriate modifiers to ensure clean reimbursement from Medicare and private payers.
By Billing Specialist on Sep 10, 2025
Stop treating all denials the same way. Implement a triage system based on denial reason, dollar amount, and appeal success rate to prioritize follow-up and maximize revenue recovery.
By RCM Strategist on Aug 29, 2025
Credentialing delays can halt your cash flow for months. We outline a proactive 90-day plan for new providers, ensuring seamless enrollment and immediate billing capabilities.
By Credentialing Expert on Aug 15, 2025
Recovery Audit Contractors (RACs) target high-level E/M codes. Learn the specific documentation elements—MDM, Time, and History—that must be present to withstand an audit.
By RAC Specialist on Aug 8, 2025