Our recent articles provide new perspectives and expert insights

Prior authorization (PA) is a necessary but often frustrating part of the healthcare reimbursement process, and the prior authorization burden it creates is substantial. While insurers use it to manage...

In today’s complex healthcare environment, revenue cycle management hinges on one crucial aspect—denial management. With payers constantly updating policies, and medical claims becoming increasingly complex, denied claims are inevitable. However,...

In the intricate dance of healthcare administration, prior authorization often feels like an unwelcome and time-consuming interruption. The manual processes involved – phone calls, faxes, and endless paperwork – not...

The rise of telehealth has revolutionized healthcare delivery, offering convenience and accessibility for patients and providers. However, this shift brings its own set of challenges, particularly when it comes to...

The healthcare industry is in constant flux, and staying abreast of the latest Medicare billing rule updates is paramount for healthcare providers. As we navigate 2025, several significant changes have...

Is your outpatient medical billing process feeling more like a tangled web than a well-oiled machine? You’re not alone. In the fast-paced world of healthcare, billing errors and inefficiencies can...

On April 4, 2025, the Centers for Medicare & Medicaid Services (CMS) issued the Medicare Advantage & Part D Final Rule for the 2026 contract year (CY) concerning the Medicare...

The final rule issued by the Biden administration aimed to bolster the privacy of reproductive healthcare data under HIPAA, a significant move following the Supreme Court’s overturning. Health and Human...

The Centers for Medicare & Medicaid Services (CMS) has unveiled its Fiscal Year (FY) 2026 IPPS Proposed Rule, which outlines significant updates to three key Medicare hospital quality initiatives: the...

Claim denials cast a long shadow over hospital finances, eroding revenue cycles, inflating administrative burdens, and ultimately jeopardizing the institution’s financial stability. While some denials are unavoidable, a powerful and...