Blogs

Neurology is one of the most cognitively demanding specialties in medicine, and unfortunately, one of the most punishing when it comes to reimbursement. Industry billing data consistently puts neurology among the specialties with the steepest denial rates in the country, with some reports placing initial denial rates anywhere from 10% up to 25%, well above the sub-5% rate most healthy practices aim for.  Between EMG/NCS studies, complex E/M visits for chronic conditions like epilepsy and multiple sclerosis, prior authorizations for high-cost infusions, and constantly shifting payer policies, neurology medical billing carries a level of complexity that most general billing teams

Orthopedics is one of the busiest corners of American medicine, and the numbers back that up. More than 18 million orthopedic procedures are performed across the country every year, and that volume is climbing fast as the population ages. Primary hip replacements are estimated to increase by 71%, and primary knee replacements are projected to increase by 85% from previous estimates by 2030, primarily as a result of the aging population, with a population greater than 65 years of age projected to more than double by 2060. Meanwhile, the number of orthopedic surgeons is declining instead of increasing. There are

Telehealth billing looks simple until a claim bounces back for the wrong place of service code, and that one detail is often the difference between getting paid and getting denied. For virtual visits, both POS 02 and POS 10 are used, and they mean two different things about the patient’s location at the time of the visit. Even if a clinical note is clean, getting that detail wrong, and pairing it up with the wrong modifier will not make the claim. The guide to Place of Service (POS) breaks down POS 02 vs 10 in plain terms, explains where modifier

A therapist submits a claim for a standard 45-minute session, uses the code she’s billed a hundred times before, and it still bounces back three weeks later. The reason? A payer quietly updated its documentation requirements, and nobody told her. If that scenario feels familiar, you’re far from alone. Across the country, behavioral health providers are losing revenue not because their clinical work is lacking, but because mental health medical billing rules keep shifting under their feet faster than most practices can track.  This isn’t a fringe complaint. It’s one of the most common complaints that psychiatrists, psychologists, licensed counselors, and group practice owners make who never were

A dermatology medical billing practice in Ohio submitted 40 claims for shave biopsies in a single month. Eleven came back denied. Not because the diagnosis was wrong, not because the treatment wasn’t medically necessary, but because the coder billed the biopsy and the destruction procedure performed on the same lesion without the right modifier, and the payer read it as duplicate billing. Eleven claims in accounts receivable, eleven calls to the payer, and a practice manager asking, “Why am I not making more money with all these claims on the books? This is the actual reality of medical billing dermatology

A single miscounted minute can cost a physical therapy practice an entire billing unit, and multiplied across a full patient panel, that adds up to real revenue lost every month.   When those errors happen repeatedly across many patients, they can lead to significant reimbursement differences over time. One of the most commonly misunderstood areas of outpatient PT billing is the Medicare 8-Minute Rule. If not used properly, clinicians risk underbilling their services or claim denials and audits.   This guide will explain exactly how the rule works, how to calculate the units properly, and where most of the practice