Stay Informed on Industry Trends, Thought Leadership, Insights and more.
What Is Revenue Cycle Management? Guide for Healthcare Providers
Revenue cycle management (RCM) is the end-to-end financial process that connects patient care to payment. Weak RCM means delayed payments, high denial rates, and cash flow strain. In...
Real-time eligibility returned active and the claim still denied: the five reasons why
An “active” eligibility result only proves the policy is in force. It never proves the service is covered, that...
CAQH Attestation Lapses: The 120-Day Cycle That Quietly Drops You From Panels
CAQH makes every provider re-attest their profile every 120 days. Miss the deadline and your profile goes inactive....
Prior authorization turnaround requirements under the CMS interoperability rule: what changed for practices
The CMS interoperability rule (CMS-0057-F) forces impacted payers to decide standard prior authorizations in 7 calendar days and...
How long Medicare PECOS enrollment actually takes in 2026, by application type
There’s no single PECOS timeline. A clean individual (855I) application clears in 30 to 60 days, and some MACs...
Denial Management in 2026: The Top 10 Codes and the Appeal Playbook for Each
Denials cluster around a small set of codes, and each one has a different correct response. Some need a...
Radiation oncology billing in 2026: what episode-based payment actually means right now
Medicare does not pay radiation oncology on an episode basis in 2026. The RO Model was shelved and never...
Podiatry billing: where DME and orthotics claims get bundled incorrectly
Most podiatry DME and orthotics denials aren’t bundling at all. They’re statutory non coverage, wrong contractor routing, or a...
Structuring patient payment plans without increasing your bad debt
A payment plan only helps if it finishes. Take 20 to 25 percent down, size the installment to the...
Renegotiating payer contracts: what your current fee schedule data needs to say first
Most practices walk into a rate conversation with a number the payer already knows is wrong. Before you ask...