OUR BLOGS

Not all billing vendors are built for Nebraska's mix of urban commercial-payer practices and rural Medicare/Medicaid-heavy clinics. Here's a transparent comparison of 10 companies, a KPI primer, an evaluation checklist, and the exact questions to ask before you sign anything.

A claim edits, and the instinct is to slap on a modifier and resubmit. That instinct is exactly how Modifier 25 and Modifier 59 get misused. This guide breaks down what each modifier actually communicates, when documentation does and doesn't support them, how the XE/XP/XS/XU family fits in, and a practical decision framework for urology billing teams in 2026.

Here's the truth nobody tells you: cardiology billing is a different beast entirely. One wrong modifier. One missed prior auth. One vague line in your documentation. And suddenly you're chasing $40,000 in unpaid claims while your staff drowns in rework. This 2026 guide pulls back the curtain on why specialty experience isn't optional it's survival. Includes a brutally honest self-assessment, a red-flags checklist, and exactly what to demand from any billing partner before you

Michigan’s complex payer landscape demands more than generic billing. Here’s how the top RCM partners stack up.

A supply claim can look simple until missing documentation or the wrong code triggers a denial. This guide covers CPT vs. HCPCS, medical necessity, common pitfalls, and a practical audit checklist.

CPT 51784 covers non-needle EMG of the anal or urethral sphincter but it lives in a coding gray zone between standalone diagnostic testing, full urodynamics workups, and biofeedback sessions where it may not be separately payable. This guide walks urology billing teams through documentation requirements, common denial triggers, a common-mistakes table, a claim-to-follow-up workflow diagram, and the specific verification steps to take before assuming reimbursement.

New CPT families, federal prior auth rules, and AI tools are reshaping urology revenue cycles. Here’s what practices must act on this year.

Learn how to correctly report CPT 52442 with base code 52441, meet documentation requirements, avoid common denials, and keep multi-implant claims clean.

Billing problems don't stay in the back office they show up as confused patients and slower collections. Here's a practical, patient-first framework for tightening dental billing: where revenue actually leaks, seven concrete fixes, a 7-question self-check, and when outsourcing is worth considering.

CPT 52332 is one of the most billed—and most denied—codes in urology. This 2026 guide covers documentation checklists, modifier rules, NCCI bundling updates, common denial triggers, and payer-specific tips to keep ureteral stent claims clean and paid.

Stop fixing the same denials over and over. Identify root causes, prevent recurrence, and turn denial data into higher collections.

There's no single Carelon timely filing number — it depends on the plan, state, and contract. See the 2026 breakdown by scenario, the most common reason claims get misrouted, and what to do if you already got a CO-29 denial.

A practical shortlist for hospitals, hospitalist groups, and critical access facilities — plus the questions most “best of” lists skip.

Payer rules keep shifting and denials keep piling up see how 10 leading hospital billing and RCM companies compare in 2026, plus a self-check to spot where your hospital's revenue might be leaking.

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Sirius Solutions Global poster with a doctor and text about CPT 59400 vs 59510 OB billing for vaginal and cesarean delivery, 2026.

One modifier determines whether a Medicare patient pays nothing for an advance care planning conversation or gets billed coinsurance for it — and most practices miss it. This 2026 guide breaks down exactly how CPT 99497 and 99498 work, the AWV pairing rule that waives cost-sharing entirely, the documentation that actually supports the time billed, and the same-day billing rules most coders get wrong.

CPT 99221, 99222, and 99223 cover the single most consequential coding decision in hospital medicine the initial visit that sets the tone, and the reimbursement, for an entire inpatient or observation stay. This 2026 guide breaks down the MDM and time thresholds that separate the three codes, the documentation each one requires, the modifier -AI rule that trips up multi-physician coverage, and the two-midnight rule considerations every hospitalist and internal medicine biller

The only state where employers can opt out of workers’ comp. See which billing partners actually handle non-subscriber claims, DWC fee schedules, and Texas auto liability.

One misapplied modifier — 26 vs. TC, or billing a global code when only one component was provided is one of the most common ways radiology claims get denied or flagged for overpayment. This 2026 guide breaks down the CPT 70000-79999 radiology section by category, the modifiers that actually matter, the documentation payers expect, and the coding shift AI-assisted imaging analysis brought this year.