Insights and Innovations in Revenue Cycle Management
The Future of Medical Billing: Top Trends to Watch for
Introduction Medical billing is no longer just about submitting claims and waiting for payments—it’s now a fast-evolving field shaped by cutting-edge technology, shifting regulations, and skyrocketing patient expectations. With innovations like artificial intelligence...
Top 7 Medical Billing Challenges in 2025 and How to Overcome Them
Medical billing is the backbone of any healthcare organization’s financial health. Yet, its complexity can feel overwhelming. With ever-changing regulations, insurance pitfalls, and the constant need for accuracy, it’s no wonder that many healthcare providers struggle...
Physician Training in Modifier and ICD‑10 Usage: Avoiding Common Pitfalls
Introduction ICD-10 modifier training is essential for physicians to ensure accurate billing, prevent denials, and comply with payer regulations. These small yet powerful suffixes attached to codes can make or break your claim submissions. Unfortunately, many...
Texas House Bill 216: Enhancing Transparency in Healthcare Billing
In an era where healthcare transparency is paramount, Texas has taken a significant step forward. House Bill 216 (HB 216), recently passed by the Texas Legislature, mandates more detailed and timely itemized billing for healthcare services and supplies. This...
Court Ruling Strengthens Provider Rights: Enforcing IDR Awards Under the No Surprises Act
A recent federal court decision is making waves in the healthcare reimbursement landscape—especially for emergency medicine providers and freestanding ERs. In a pivotal case, a court has recognized a private right of action for providers to enforce Independent Dispute...
The Impact of Forced Consolidation of Emergency Medicine Groups
The emergency medicine landscape is undergoing rapid transformation, and one of the most significant shifts in recent years is the forced consolidation of independent emergency medicine groups (EM). As pressures from policy changes, reimbursement cuts, and health...
Emergency Medicine Feels the Impact: 39% Reduction in Out-of-Network Reimbursement Since No Surprises Act
A recent survey by the Emergency Department Practice Management Association (EDPMA) has confirmed what many emergency medicine groups have already experienced firsthand: a significant drop in out-of-network reimbursement since the No Surprises Act (NSA) took effect....
Understanding the Payment Landscape: What RAND’s Latest Hospital Price Transparency Study Means for Emergency Medicine Providers
The RAND Corporation recently released its latest hospital price transparency study, analyzing the rates that private insurers pay hospitals and ambulatory surgical centers (ASCs) across the United States. The findings, based on claims data from 2022, continue to shed...
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