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Introduction As of mid-2025, U.S. doctors face a critical inflection point in how they are paid for services under Medicare. The convergence of two trends—updated Medicare reimbursement policies and the evolving telehealth billing framework—has reshaped revenue streams across nearly all…
Introduction In January 2025, the Centers for Medicare & Medicaid Services (CMS) implemented the fifth consecutive annual cut to its Physician Fee Schedule (PFS), reducing the conversion factor from approximately $33.29 to $32.35, a 2.83% decrease (ascopost.com, cms.gov). This reduction…
Introduction In recent years, U.S. healthcare has been steadily moving away from traditional fee‑for‑service billing and toward value‑based care (VBC) and bundled‑payment models. These frameworks link physician compensation to patient outcomes, quality of care and overall cost control. As CMS…
Introduction In 2025, artificial intelligence (AI) and automation are taking centre stage in medical billing and coding—offering the potential to streamline workflows, reduce errors, and alleviate administrative burdens. Recent industry surveys reveal that AI tools have surpassed EHR usability as…
Introduction The landscape of medical billing is undergoing major transformation with planned transition from ICD‑10 to ICD‑11 in United States. While ICD‑11 was officially released by World Health Organization (WHO) in January 2022, its practical implementation across countries is ongoing.…
In today’s increasingly complex healthcare environment, many physicians and small medical practices are turning to outsourcing medical billing services as a cost-effective, efficient way to streamline operations and increase revenue. Whether you’re running a solo practice or a small clinic,…
Claim denials are one of the biggest obstacles to steady cash flow in healthcare practices. Whether due to missing documentation, incorrect codes, or payer-specific rules, denied claims slow down reimbursement, frustrate staff, and increase administrative overhead. Understanding the top reasons…
In today’s healthcare environment, data breaches are a growing concern—especially in medical billing, where sensitive patient information is handled daily. The Health Insurance Portability and Accountability Act (HIPAA) sets the national standard for safeguarding protected health information (PHI), and its…
Accurate medical coding is essential to ensure timely reimbursements, prevent claim denials, and stay compliant with payer and federal guidelines. For healthcare providers, keeping up with the latest CPT code updates and ICD-10 coding guidelines for 2025 is more than…
Efficient Revenue Cycle Management (RCM) lies at the heart of every financially healthy healthcare organisation. From patient registration to final payment, the revenue cycle includes every step that influences how and when a provider gets paid. Yet, for many clinics…
