Practical guidance on denials, compliance, and payer behavior from a team that works these problems every day.
Every year from October 15 to December 7, Medicare beneficiaries can switch Medicare Advantage plans, change Part D coverage, or move between Medicare Advantage and Original Medicare. Every change takes effect on January 1.
CMS has published the final list of physicians required to participate in the Ambulatory Specialty Model (ASM) for the 2027 performance year. If you manage low back pain in an outpatient setting, and your practice sits in one of the metro areas CMS selected, your Medicare revenue in 2029 will partly depend on what happens in your practice starting this January.
Insurers Say They Cut 6.5 Million Prior Authorizations. Most Practices Cannot Find Them. In June 2025, more than fifty health plans covering roughly 270 million
Three Medicaid Changes Land on January. Your Eligibility Workflow May Not Be Ready for Them. Most of the conversation about the One Big Beautiful Bill
Boutique RCM vs. Big-Box Billing: What Specialty Practices Actually Need Outsourced revenue cycle management is no longer a niche decision. Industry research shows the outsourced
The New CMS Prior Authorization Rules Are Here. So Why Are Denials Still Rising? On January 1, 2026, the most significant federal prior authorization reform
BCBS Michigan’s 50% Modifier 25 reimbursement cut is paused, but the audit wave isn’t. Here’s what every practice billing same-day E/M and procedures needs to do now.
Claim denial rates keep climbing in 2026. Learn why denial prevention beats denial management, and how to stop revenue leakage before claims are ever submitted.
