The Money You Can’t See on Your Denial Report
Every revenue cycle meeting starts with the same chart. Denial rate, month over month, usually trending down if the practice…
Category: Business View
When a Payer Policy Changes, Who Actually Updates the Claim?
A payer publishes a policy bulletin. Somewhere in a portal, a newsletter, or an email, a change takes effect: a…
The Referral Was Made. The Patient Was Seen. The Practice Still Lost the Revenue.
The referral went out. The patient made the appointment. The specialist saw them, documented the visit, and submitted the claim.…
The Claim Was Paid. So Why Is Your Revenue Still Wrong?
A claim goes out. A payment comes back. The balance drops to zero, and the account closes. In most billing…
The $700,000 HIPAA Lesson Hidden Inside One Phishing Attack
A phishing attack compromised one employee’s email account. That’s how this story starts. But the $700,000 figure at the end…
Your Claims Aren’t Being Denied. They’re Being Taken Back.
Why lower denial rates may be hiding a new revenue-cycle problem for medical practices Here’s a number that should stop…
Why Anthem Is Penalizing In-Network Hospitals for Out-of-Network Doctors
By Elena Pak, Credentialing Department, WCH Elevance Health, the parent company of Anthem Blue Cross Blue Shield, is facing another…
Are You Leaving Money on the Table? 5 Revenue Opportunities Physicians May Be Missing in 2026
Your practice may already be doing work that payers reimburse — without fully capturing the revenue. Not because of dishonesty.…
The Payer Changed the Rules. Did Your Practice Change With Them?
A payer bulletin is not useful until someone translates it into a change in what your staff actually does. That’s…
Your 2026 Medicare Revenue May Depend More on Where You Practice Than What You Bill
Same CPT code. Same clinical service. Same patient outcome. Different building — and, in a growing number of cases, a…