Clean Claim Rate: Hitting At Least 97% Consistently (Not a Stretch Goal) Most revenue cycle managers can tell you their clean claim rate off the top of their head. What they usually cannot tell you is which two or three things are keeping it below 97%. HFMA puts industry initial denial rates above 11%, and…
Charge Capture: Top 10 Leakage Points in Ambulatory Practice Ambulatory practices lose between 3% and 5% of net patient revenue to charge capture failures every year. On a $5 million practice, that is up to $250,000 annually, and none of it shows up as a denial. The work happened. The money just never made it…
Ambulatory Surgical Center EHR Surgical centers that reinvent their operating core grow faster and lose less.Ambulatory surgical center software from OmniMD integrates EMR, EHR, facility billing, OR scheduling, quality reporting, and compliance in one platform. Built for how surgical centers operate. Not adapted from how hospitals do. Why Most ASCs Are LosingMoney on Technology Half…
Self-Pay & Patient Payment Plans: A Cash-Flow Playbook for Medical Practices The financial relationship between practices and patients has fundamentally changed. What was once a predictable transaction, bill the insurer, collect a small copay, has become one of the most operationally demanding parts of running a medical practice. Patient payments now account for approximately 35%…
New vs Established Patient Billing: What the 3-Year Rule Actually Means A patient walks into your practice for the first time in four years. Your front desk marks them as established. Your biller codes accordingly. Your claim goes out, and six months later, it surfaces in an OIG audit as upcoding. The 3-year rule got…
Mental health billing that actually recovers your revenue Psychiatric billing carries the highest denial rate in healthcare. OmniMD’s dedicated mental health team brings the specialty-specific expertise your practice needs, to get paid accurately, faster, and in full. Mental health billing isn’t like other specialties Session based coding structures, payer-specific behavioral health rules, prior authorization requirements,…
ASC Accreditation: What It Takes to Get Certified and Stay Compliant Ambulatory surgery centers face a compliance environment that does not pause between survey cycles. Every patient encounter, every documented procedure, every staff credential sits within an interlocking framework of clinical standards, federal requirements, and accreditation expectations. For most ASCs, the stakes are concrete: accreditation…
2027 Prior Authorization Readiness Checklist for Medical Practices Updated October 2026: Confirmed the CMS-0057-F January 1, 2027 API deadline is unchanged, and checked the current status of the proposed drug-coverage extension below. Prior authorization has always been a drain. But in 2027, it becomes something more serious: a compliance benchmark, a financial pressure point, and,…
The Best Alternative to Epic Systems for Solo, Small, and Mid-Sized Clinics There is a reason Epic Systems is the name that comes up every time someone talks about electronic health records. It has been earning that reputation since 1979. And for large hospital networks, academic medical centers, and multi-specialty health systems, that reputation is…
ICD-10 codes for prenatal care, delivery, ovarian cysts, and menopause. CPT codes for obstetric global packages and gynecologic procedures with billing tips. FY 2026.
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