Accurate medical billing depends on much more than selecting the correct CPT® and ICD-10-CM codes. Another important claim element is the Place of Service (POS)
Medicare coverage can change from year to year. Premiums may change. Prescription drug formularies may change. Provider networks may change. Copayments, deductibles, benefits, and pharmacy
Healthcare organizations are under constant pressure to improve collections, reduce denials, accelerate cash flow, and control operating costs. At the same time, Revenue Cycle Management
The Affordable Care Act (ACA) Marketplace landscape for plan year 2027 has changed following federal court action involving several provisions of the 2027 Marketplace regulations.
The annual ICD-10-CM update is one of the most important dates on the medical billing and coding calendar. For FY 2027, healthcare organizations need to
If you’re starting a career in US Medical Billing, one of the first concepts you need to understand is the difference between the CMS-1500 claim
If you’re learning about Medicare, you’ve probably heard terms such as Original Medicare, Medicare Advantage, Medigap, Part A, Part B, and Part D. For beginners,
If you’re starting a career in US Medical Billing, two of the most important healthcare programs you will encounter are Medicare and Medicaid. Although both
Prior Authorization (PA) is one of the most important processes in the US healthcare revenue cycle. Before certain healthcare services are performed, an insurance company
Medical billing compliance is no longer simply about submitting claims and waiting for payment. Healthcare organizations must also make sure that the services they bill
The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2027 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC)
The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2027 Medicare Physician Fee Schedule (PFS) Proposed Rule on July 14, 2026.