Medical Credentialing Requirements for Medicare, Medicaid, and Commercial Payers
Medical credentialing is one of the most important steps in starting or expanding a medical practice — yet it’s also one of the most confusing. Every payer has its own rules, its own forms, and its own timelines. And if a provider is not properly credentialed, claims will be denied, payments will be delayed, and […]
The Most Common Medical Billing Errors and How to Correct Them
Medical billing in the U.S. can feel like navigating a maze. Even tiny mistakes can lead to denied claims, lost revenue, compliance headaches, and frustrated patients. According to recent medical billing errors statistics, around 80% of medical bills contain an error. Those errors add up, costing providers billions in denied or underpaid claims each year. […]
Revenue Cycle Metrics That Matter for Smaller Practices
If you run a small medical or dental practice, keeping the lights on means more than just seeing patients — it means making sure the money you bill actually comes in reliably and quickly. That’s where the revenue cycle comes in: from registration to payment, every step matters. But with limited staff and resources, smaller […]
Why Every Practice Needs a Defined Medical Billing Structure
Running a medical practice is about more than caring for patients – it’s also about keeping the financial side strong. For small practices and solo physicians, every dollar matters. Yet many still operate without a clearly defined medical billing structure. At first, the gaps may not be obvious. Claims are filed, payments eventually arrive, and […]
No Trust in Your Medical Billing Service? Here’s How to Fix It
Imagine finishing a long clinic day only to find billing errors, unpaid claims, and patient complaints stacking up. You outsourced your billing to save time and reduce stress, but instead you feel more anxious. You’re left asking: “Can I even trust our billing company?” If this sounds familiar, you’re not alone. Many medical practices across […]
The High Cost of Denied Claims: Stop Leaving Money on the Table
Running a hospital, clinic, or medical practice is more than caring for patients—it’s also about keeping the business side healthy. One of the biggest challenges practices face today is denied claims. These denials quietly eat into your revenue, disrupt cash flow, and often create more work for your staff. In fact, industry studies show that […]
How a Shortage of Medical Billing Staff Disrupts RCM for Hospitals
Revenue Cycle Management (RCM) is the lifeline of every hospital and healthcare system. It’s the process that ensures services provided to patients are properly billed, claims are submitted on time, and payments are collected without delay. But what happens when there aren’t enough hands on deck? A shortage of medical billing staff can quietly and […]
How Poor Communication Hurts Revenue Cycle Management (RCM) and How to Fix It
When communication fails in Revenue Cycle Management (RCM), it leads to lost revenue, denied claims, and unhappy staff and patients. U.S. hospitals lose an estimated $12 billion each year due to delays, duplicate work, and missed handoffs—all caused by poor communication. For healthcare providers and RCM teams, these breakdowns aren’t just annoying—they hurt the bottom […]
Why AR Follow-Up is the Lifeline of Medical Billing—and What Happens When You Ignore It
In the world of U.S. healthcare, collecting payments isn’t always as simple as sending a bill and waiting for a check. Behind every dollar collected is a process called AR Follow-Up in medical billing—and it’s the lifeline of any medical practice’s financial health. Yet many providers don’t realize just how critical this step is until […]
Delayed Claim Submission: Causes, Impacts, and Prevention Strategies
In the world of medical billing, timing is everything. Delayed claim submission occurs when a healthcare provider waits too long to send an insurance claim for reimbursement after services are provided. These claim delays – also termed late medical claims or submission delays – can quietly undermine a practice’s financial health. When claims aren’t submitted […]