Internal Medicine Billing: Reducing Denials on Chronic Care Management Claims
Chronic care management (CCM) billing should be one of the more predictable revenue streams for an internal medicine practice. The patients are already there, the care is already happening, and the codes are well established. Yet CCM claims are denied at a higher rate than most practices expect, usually not because the care wasn’t provided, […]
Gastroenterology Billing: Colonoscopy and Endoscopy Coding Mistakes
Gastroenterology practices handle a steady volume of colonoscopies and endoscopies, and that volume means even a small, repeated coding mistake can add up to a meaningful amount of lost revenue over a year. Unlike many specialties, GI billing also has to navigate a rule that trips up a lot of practices: the difference between a […]
Pediatric Billing: Vaccine Coding and Well-Child Visit Reimbursement
Pediatric practices run on a different billing rhythm than adult medicine. A huge share of visits are preventive rather than problem-focused, and a single well-child appointment can generate a dense stack of codes: an office visit, several vaccine products, and multiple administration codes, sometimes with a sick-visit modifier layered on top. Get any one of […]
Gastroenterology Billing: Colonoscopy and Endoscopy Coding Mistakes
Gastroenterology practices run on procedure volume — colonoscopies, upper endoscopies, ERCPs, and EUS cases fill the schedule every week. That volume is exactly why gastroenterology billing is so easy to get wrong. A single mismatched diagnosis code on a routine screening colonoscopy can shift the entire claim from a no-cost preventive service to a patient […]
Cardiology Medical Billing: Common Denial Reasons and How to Fix Them
Cardiology practices run some of the most complex billing in medicine. A single visit can involve an evaluation and management code, a diagnostic test, a procedure, and several modifiers, all tied to the right ICD-10 diagnosis. Every one of those pieces has to line up correctly, or the payer sends the claim back. Industry estimates […]
HIPAA Compliance in 2026: What Healthcare Providers Can Learn From a $703 Million Medicare Fraud Case
Healthcare organizations are facing a rapidly changing compliance environment in 2026. Patient information is increasingly digital, medical billing is more interconnected, and cybercriminals and fraud networks are finding new ways to exploit sensitive healthcare data. A recent case involving approximately $703 million in alleged fraudulent Medicare claims demonstrates just how valuable patient and beneficiary information […]
Internal Medicine Billing: Reducing Denials on Chronic Care Management Claims
Chronic care management (CCM) billing should be one of the more predictable revenue streams for an internal medicine practice. The patients are already there, the care is already happening, and the codes are well established. Yet CCM claims are denied at a higher rate than most practices expect, usually not because the care wasn’t provided, […]
General Surgery Billing: Global Period Rules Every Practice Must Know
Few concepts cause more denied claims and repaid overpayments in general surgery billing services than the global surgical period. A single miscoded post-op visit or a missing modifier can turn a fully reimbursable claim into an audit flag — or worse, revenue your practice never sees again. Every general surgeon bills under a global period, […]
Gastroenterology Billing Services: Colonoscopy CPT Codes and How to Prevent GI Denials
Colonoscopies are one of the highest-volume procedures in gastroenterology, and one of the most frequently mis-coded. A single visit can shift from screening to diagnostic mid-procedure, carry different rules depending on whether the payer is Medicare or a commercial plan, and involve multiple add-on codes for biopsies or polyp removal performed in the same session. […]
Family Medicine Billing: Maximizing Reimbursement for Preventive Visits
Preventive care is supposed to be the easy money in family medicine. No prior authorizations, no complex surgical bundling, just a patient coming in for their yearly checkup. Yet preventive visits are quietly one of the most under-billed services in primary care, and the gap almost always comes down to coding, not care. Family practices […]