Discover expert insights and practical tips to simplify medical billing and boost your practice’s financial success.
Why Medical Billing Services Are Crucial Right Now The healthcare sector is on the brink of sweeping changes. Planned reductions to Medicaid risk stripping coverage from millions and lowering reimbursement levels, forcing medical practices to act quickly to protect their financial health. But in the midst of this chaos, a
How Medicare Advantage Denials Are Fueling a Healthcare Crisis More than half of Medicare-eligible individuals are in MA plans by 2025. While plans were designed to enhance care options, they are now more closely tied to severe issues confronting healthcare providers. A sharp spike in claim denials most often for
Recap: What Does the No Surprises Act Cover? Since we are halfway through 2025, the No Surprises Act (NSA) is now being strictly enforced. Last year, the focus was on training and adjusting to the new rules, but this year it is all about enforcing everyone to follow them. The
In 2022, American hospitals lost a projected $68 billion on billing mistakes, wrong codes, rejected claims, and lost payments majorly from in-house systems. That is not a typo. That’s the high cost of problems in a system that struggling with complexity, labor shortages, and regulatory overload For thousands of healthcare providers,
How we are paid for behavioral health is evolving quickly. In 2025, providers will have to navigate a lot of new codes, policies, and technologies. Demand for mental health and substance use treatment grew during the pandemic. Telehealth visits for care grew from around 1% prior to 2020 to more
Effective July 1, 2025, the AMA released new Proprietary Laboratory Analysis (PLA) codes and made some revisions. There are 23 new PLA code updates (0552U–0574U) approved by the CPT Editorial Panel, one code revised, and six others removed. These changes will be found in CPT 2026 released in October 2025
Congressional leaders are considering a broad budget proposal known as the 2025 reconciliation bill that would significantly transform federal programs. Among the areas of top concern is Medicaid, the federal health program for low-income adults, older adults, people with disabilities, and many children. Currently, roughly 71 million Americans are on
Imagine doing all the right things for patient care and forgetting a simple deadline and losing Medicare payments. The Merit-based Incentive Payment System (MIPS) has a lot of significant dates each year. If you participate in MIPS for 2025, here’s the timeline you need to be aware of. Forgetting a
Medical credentialing is the pivotal process of checking the credentials, licenses, and background of healthcare providers. In 2025, it will see radical transformations. As healthcare continues to transform further, Medical Credentialing in 2025 will need greater attention, velocity, and active monitoring than ever before. The new regulations this year require
Imagine running your medical practice in 2025: staff and supply expenses continue to rise, but reimbursement for your services continues to shrink. That’s the reality of healthcare finance in 2025, and it keeps a lot of physicians anxious about profiting with their practice. Value-based care (VBC) – a system that
