Medical Billing

ASC Billing Guidelines: What Every Surgery Center Needs to Know CMS is adding 573 new procedure codes to the ASC Covered Procedures List in 2026. Payment rates are adjusting. Quality reporting penalties are in effect. And across the more than 6,300 Medicare-certified ASCs treating nearly 3.4 million fee-for-service beneficiaries annually, the difference between a well-run…

Podiatry Billing: Routine Foot Care & Medicare LCDs Medicare excludes routine foot care from coverage under the Social Security Act, Section 1862(a)(13). That means trimming toenails, cutting corns, and general preventive foot maintenance are not covered services on their own. Medicare considers them maintenance, not treatment. But there is a documented exception. And that exception…

How AI Medical Coders Catch $150K in Missed Revenue Per Year This is a story from one of our clients. At first glance, nothing seemed off. They had twelve physicians, about 280 patient visits a week, and a solid billing team with three experienced coders. But something kept bothering the practice manager. Every month, the…

Physical Therapy Billing: The 8-Minute Rule Explained In most medical specialties, the time a surgeon or a physician spends delivering a service rarely changes what gets billed or how much. However, physical therapy works on an entirely different logic. In PT, time is not just a background detail in the note. Time is what determines…

Payer Underpayment Recovery: The Hidden 15% Revenue Gap Healthcare organizations spend enormous effort improving denial management, reducing AR days, and accelerating collections. Revenue cycle teams monitor rejected claims closely because denials create immediate operational pressure and visible disruptions to cash flow. But one of the largest sources of revenue leakage often receives far less attention:…

How to Read an EOB in Medical Billing and Catch Underpayments in 10 Minutes By the time the EOB arrives, most teams have already moved on to the next claim. The work is done, the patient has left, and the claim has been processed through the medical billing clearinghouse and on to the payer. So…

The 7 Most Common Claim Denials and How to Appeal Each One I sat in on a customer call a few months back. The billing director of a 40-provider orthopedic group was going through her denial worklist with me. In about twenty minutes, she wrote off $11,000 worth of claims. Most of them, she admitted,…

AI in Medical Billing: Top 5 Platforms Compared (2026) At a glance Platform Best for Starting price Big win Watch out for CodaMetrix Big hospitals that want autonomous medical coding Custom (by volume) KLAS #1 in autonomous coding for 2026; cuts manual coding work by up to 70% Costs a lot up front; not for…

How to reduce claim denials by 50% in 90 days  You probably didn’t open this blog randomly. Chances are, someone just walked into your office (or pinged you on Slack) asking why denials keep climbing, and you’ve got maybe ninety days to come back with a real answer. The number in your head, 10%, 14%,…

Physical Therapy Billing Services Compared: Which Vendor Actually Reduces Denials by 32.5%+? Key Takeaways Vendor Pricing Clean Claim Rate Key Credential Biggest Strength Biggest Trade-off WebPT + Therabill $99/provider/mo plus 6.5% of collections for RCM 98.50% Best in KLAS 2024 (Outpatient Therapy) Deepest PT-specific workflows; 150,000+ PT users Two separate systems to manage; documented billing…