How to Outsource Medical Billing: Step-by-Step Guide for Practices
Every year, U.S. practices lose an estimated 4–5% of their revenue to billing inefficiencies — a figure that, for a practice generating $3 million annually, translates to $150,000 in unrealized income. At the same time, initial claim denial rates climbed to 11.6% in 2025, up from 10.2% just five years prior, according to Kodiak Solutions’ […]
Medical Billing Audit: What It Is, Why You Need One & How to Do It
In fiscal year 2024, the Medicare Fee-for-Service program recorded an estimated improper payment rate of 7.66%, representing $31.70 billion in payments that were incorrect, according to CMS. The American Medical Association estimates that up to 12% of medical claims are submitted with inaccurate codes, and coding mistakes account for approximately 32% of first-submission claim denials. For most practices, those numbers […]
Physical Therapy Billing: Codes, Rules & Best Practices
What Is Physical Therapy Billing? Physical therapy billing is the process through which physical therapy practices submit claims to insurance payers and collect reimbursement for the services they provide. Like all medical billing, it involves translating clinical services into standardized codes, submitting those codes to the right payer, and following up to ensure payment is received. What makes physical […]
Chiropractic Billing: Codes, Common Denials, and How to Get Paid Faster
Chiropractic billing operates in one of the most scrutinized billing environments in U.S. healthcare. The American Chiropractic Association’s 2024 research found that approximately 30% of initial chiropractic claims are denied, a rate nearly three times the national average for most outpatient specialties. For context, the CMS Comprehensive Error Rate Testing (CERT) program documented an improper payment rate of 43.9% to 54.1% […]
Mental Health Billing: A Complete Guide for Therapists & Behavioral Health Practices
Behavioral health providers deliver care that is clinically complex, emotionally demanding, and operationally underappreciated — particularly when it comes to getting paid for it. Mental health claim denial rates are 85% higher than those for comparable medical services, according to the Mental Health Treatment and Research Institute’s 2024 Behavioral Health Parity Report. That gap is not […]
Cardiology Medical Billing: Codes, Challenges & Best Practices
Cardiology is one of the most procedure-intensive specialties in U.S. healthcare, and its billing complexity reflects that. From routine electrocardiograms to multi-code catheterization claims, every encounter demands precision. The financial stakes are significant: cardiology practices face denial rates of 15 to 20 percent, far higher than most specialties, driven by predictable triggers including missing prior authorizations, […]
Medicaid Billing Guide for Healthcare Providers (2026)
Medicaid is one of the largest payers in the U.S. healthcare system, covering nearly one in five Americans and accounting for close to one in five dollars spent on healthcare in the country. Total Medicaid spending reached $919 billion in federal fiscal year 2024, with 65% financed by the federal government and the remaining 35% by states. For any practice serving low-income […]
How to Negotiate Payer Contracts Using Market Rate Data
Most practices that struggle in payer contract negotiation are not underprepared in the conventional sense. They know their fee schedules. They track their denial trends. They show up to the table ready to make a case. What they are often missing is the one asset payers already have in abundance: a detailed picture of what […]
Prior Authorization in Medical Billing: Everything You Need to Know
According to an AMA survey, physicians now handle an average of 43 prior authorization requests per week, consuming roughly 12 staff hours that could otherwise be spent on patient care. That figure, reported in 2025, represents a meaningful increase from previous years and reflects a system under growing administrative strain. For healthcare practitioners, practice managers, and revenue cycle teams across the […]
Medicare Medical Billing: Rules, Codes & Common Pitfalls (2026)
Medicare is the single largest payer in the U.S. healthcare system, and for most practices, getting Medicare billing wrong is expensive in ways that are rarely visible until the damage is done. According to the American Medical Association, up to 12% of medical claims are submitted with inaccurate codes, and poor billing practices cost U.S. providers an […]