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Healthcare Articles & Industry Insights

Your trusted source for expert insights on medical billing, coding, revenue cycle management, credentialing and healthcare operations. Stay informed with analysis and guidance built for practice leaders and healthcare administrators, updated regularly to keep you ahead of industry shifts. 

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Prior Authorization for GLP-1: What Providers Need to Know

Prior Authorization for GLP-1 Medications: What Providers Need to Know

Key Takeaways GLP-1s require prior authorization because the same drug can be

AB 1041: What California Providers Need to Know

AB 1041: What California Providers and Health Plans Need to Know About the New Credentialing Law

Key Takeaways AB 1041, authored by Assemblymember Bennett, was signed into law

CMS 0057: What Providers Need to Know About the New Prior Authorization Rule

CMS 0057: What Providers Need to Know About the New Prior Authorization Rule

Key Takeaways CMS 0057 (CMS-0057-F) regulates payers, not providers, but reshapes prior

CountyCare Prior Authorization Changes 2026: What Providers Must Know

CountyCare Prior Authorization Changes 2026: What Illinois Providers Need to Know

Key Takeaways Illinois practices billing CountyCare must cross-reference every medical-benefit drug they

Remote Patient Monitoring Companies in 2026 (Top 10 Ranked)

Top 10 Remote Patient Monitoring Companies in 2026

Key Takeaways Remote patient monitoring reached nearly one million Medicare enrollees in

8 Ways Outsourced Credentialing Improves RCM

8 Ways Outsourced Credentialing Improves RCM

Key Takeaways Practices exploring outsourced credentialing RCM improvements should know that accurate

In-House Credentialing Mistakes to Avoid

9 In-House Credentialing Mistakes to Avoid in 2026

Key Takeaways Parallel processing of credentialing and payer enrollment, rather than sequential

How to Manage Denials Post-OBBBA

How to Manage Denials Post-OBBBA

Key Takeaways Eligibility verification at every visit, not appeals or coding fixes,

Sinus Surgery Reimbursement: Why FESS Claims Trigger Payer Recoupments (and How to Defend Them)

Sinus Surgery Reimbursement: Why FESS Claims Trigger Payer Recoupments (and How to Defend Them)

Key Takeaways Sinus surgery reimbursement recoupment happens when payers reprocess paid FESS

REMS-Ready Spravato Billing: The Compliance Checklist Every Practice Needs

REMS-Ready Spravato Billing: The Compliance Checklist Every Practice Needs

Key Takeaways Spravato REMS billing compliance is a payment prerequisite — a

Top 10 RCM Companies in Arizona for 2026: Best Revenue Cycle Management Partners

Top 10 RCM Companies in Arizona for 2026: Best Revenue Cycle Management Partners

Key Takeaways Selecting an RCM partner in Arizona depends on matching specialty,

Neolytix Identifies an Average of $341K in Payer Contract Revenue Opportunities — Get Your Assessment Done Today

Illinois HB 1085 Simplified

How BH Practices Can Capture the Multiple Revenue Streams It Unlocks

HB 1085 sets a permanent 141.7%-of-Medicare reimbursement floor for Illinois commercial behavioral health plans renewing on or after January 1, 2027. It opens several revenue opportunities that do not unlock automatically. Join us to learn what you need to do before January 1 to capture all of them.
Jay Reeser
Jay Reeser
VP Payer Analytics (ex-Cigna, UHC)
Brian Morefield
Brian Morefield
Director, Business Development