Medical Billing Services

Florida healthcare practices are growing rapidly, but billing complexity is growing even faster. Payer scrutiny, frequent claim edits, staffing shortages, and specialty specific coding rules have made revenue cycle management one of the most resource intensive functions for providers. Even a single delayed claim or missing modifier can impact patient experience and disrupt cash flow. […]

New Jersey’s healthcare ecosystem is among the most dynamic in the country. The state’s high patient density and strong payer mix, from Horizon Blue Cross Blue Shield to Aetna, AmeriHealth, and UnitedHealthcare, make revenue management both vital and complex. Small clinics, hospital-affiliated groups, and specialty practices all face a similar challenge: how to keep billing […]

Healthcare providers in Pittsburgh operate in one of the most diverse payer markets in the Mid-Atlantic region. From large health systems to independent practices, reimbursement management has become more complex as payer scrutiny increases and compliance expectations tighten. Industry data shows that claim denials continue to be a major revenue drain. In 2024, nearly four […]

California has one of the most complex healthcare billing environments in the United States. Practices must manage a mix of private payers, Medi-Cal, workers compensation programs, and value-based reimbursement models, all while staying compliant with strict state and federal regulations. Even minor billing errors can lead to delayed payments, audits, or revenue loss. The U.S. […]

In 2025, high-volume oncology clinics forfeit $15,000+ per denied chemotherapy infusion from unverified expired coverage per MGMA benchmarks, with eligibility errors fueling 30–40% of front-end denials and inflating A/R beyond 50 days even in streamlined workflows, exposing how payer variability and manual checks hemorrhage 10–41% of claims in high-stakes services like J-codes for oncology drugs, […]

Appeals represent one of the most time-intensive and error-sensitive stages of the revenue cycle. Denial Rates are now high with a recent report finding that shows at least one in every ten claims being denied. When the denial volume grows and the staff bandwidth stays fixed, appeal accuracy and turnaround time begin to slip. Multi-specialty […]

If you work in medical billing, you’ve probably run into Denial Code OA 23 more often than you’d like. It appears when a secondary payer adjusts a claim based on what the primary payer has already covered or modified. This happens frequently in multi-insurance situations where coordination of benefits becomes unclear. These denials stack up […]

Point-of-Care (POC) documentation refers to recording patient information in real time during the clinical encounter. It is the process in which healthcare providers record patient information electronically at the patient’s bedside or wherever the care is being delivered, using mobile devices like tablets or portable computers. This approach replaces the traditional method of writing notes […]

Healthcare organizations use several standard code sets when billing payers. CPT and HCPCS codes describe procedures and supplies. ICD-10 codes define diagnoses and patient conditions. Revenue codes are different. They identify the department or type of service provided in a facility setting. Even though they may not explain a clinical service on their own, they […]

Claim denials are one of the biggest barriers to smooth reimbursement. Even when workflows seem well-organized, denials can still disrupt cash flow and increase administrative workload. They also slow down the revenue cycle and create unnecessary rework. Recent industry reports show denial rates have risen sharply in the past two years. Many of these are […]