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Revenue Cycle Management (A/R & Denials)
Practical guides to accounts receivable, denials, appeals and revenue cycle metrics, so you can find where money is leaking and fix it.
71 guides
Revenue Cycle Assessment Checklist: What a Practice Audit Should Check
What a whole-cycle revenue assessment should review, from lead source to audit log: the reports to pull, six KPIs with published formulas and a simple scoring table.
Medicare Enrollment for New Providers: PECOS and CMS-855I Step by Step
The order of Medicare enrollment for a new physician or NPP joining a group: NPI, PECOS access, CMS-855I with reassignment, effective dates, revalidation and CAQH.
Year-End Accounts Receivable Cleanup Checklist for Medical Practices
A December checklist for medical practices: work A/R by payer and deadline, file and appeal before Medicare limits close, settle credit balances and snapshot your KPIs.
January Deductible Reset: Eligibility and Patient-Estimate Checklist
Deductibles restart and plans change on January 1. Use this checklist to re-verify every patient, estimate what they owe, give self-pay patients a Good Faith Estimate and collect at the...
Revenue Leakage in Healthcare: 4 Handoffs Where Practices Lose Money
Most lost revenue in a medical practice starts at a handoff, not in the billing office. Here are the four handoffs where money slips, who should own each one and...
Denial Root Cause Analysis: A Monthly Workflow for Medical Practices
A six-step monthly workflow for medical practices: pull remittance data, group denials by CARC/RARC and by where they start, assign owners, fix upstream and track the results.
2027 CPT Code Changes and the Medicare Fee Schedule: A Checklist
CPT 2027 brings 453 code changes on January 1, alongside a new Medicare fee schedule and quarterly HCPCS and NCCI updates. Here is what changed and a checklist to get...
Denial Management in Medical Billing: Process, Codes, Appeals
A practical guide to denial management in medical billing: the five-step process, the reason codes that recur, Medicare appeal windows and how to decide who should work your denials.
Recoupment in Medical Billing: What It Means and How to Respond
What payer recoupment means, the Medicare day-by-day timeline, how commercial rules differ and a checklist for responding to a recoupment notice.
Understanding the Steps in Payment Posting for Revenue Cycle Management
Discover essential steps in payment posting, enhancing cash flow and reducing claim denials for healthcare providers. Optimize your RCM today!
Medical Billers and Coders: Roles in the Revenue Cycle
Medical billers and coders are two of several roles that move a visit to a paid claim. See who owns each step, where handoffs fail, and how to staff them.
Unpaid Medical Bills: What Practices Should Know
What happens to unpaid medical bills, for the patient and for your practice, which rules shape collections, and how to follow up fairly without hurting cash flow.
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