How Small Practices Lose Revenue Between Claim Submission and Payment
For many small practices, the most confusing billing problem isn’t outright denials—it’s revenue that quietly disappears after claims are submitted. […]
For many small practices, the most confusing billing problem isn’t outright denials—it’s revenue that quietly disappears after claims are submitted. […]
Improving collections is one of the most common goals we hear from small practices—and one of the hardest to achieve
Choosing a medical billing partner is one of the most consequential operational decisions a small practice makes. In our work
Outsourcing medical billing is often framed as a cost decision. In real-world practice operations, it’s more often a capacity and
Launching a new medical practice is operationally intense. Between licensing, credentialing, staffing, and patient care, billing often becomes an afterthought—until
Credentialing delays are one of the most underestimated financial risks for small medical practices. In our credentialing and billing work
Insurance follow-ups are one of the most overlooked—and financially damaging—parts of billing operations in small practices. In our billing work
Many small practices take comfort in seeing claims marked as clean by their clearinghouse or EHR. In theory, a clean
For many small and independent practices, “medical billing” is often misunderstood as just submitting claims and waiting for payments to
Claim denials are one of the most frustrating—and expensive—parts of billing for small medical practices. In our billing work with
In small medical practices, accounts receivable aging rarely becomes a problem overnight. It builds quietly—claim by claim, week by week—until
Small and solo medical practices rarely fail at billing because they don’t know how to submit claims. In our billing
Small and solo medical practices rarely struggle because they “don’t understand billing.” In our billing work with small practices, the
Small and solo medical practices often feel blindsided by billing problems. Claims are coded correctly. Documentation is complete. Submissions go
For small medical practices, billing costs are often misunderstood. Many providers assume that outsourcing medical billing is expensive, while others
Small medical practices face a constant balancing act: delivering quality patient care while managing increasingly complex administrative and billing requirements.
Private practice clinics occupy a challenging middle ground. They are no longer small enough for informal, ad-hoc billing processes, but
Running a solo medical practice means wearing multiple hats—provider, administrator, compliance officer, and business owner. In our billing work with
DME credentialing is one of the most detail-heavy administrative processes in the healthcare industry. Because Medicare, Medicaid, and commercial insurers
DME credentialing is one of the most operationally demanding tasks for a durable medical equipment supplier. Enrolling with Medicare, Medicaid,
DME credentialing is one of the most detailed and compliance-driven areas in healthcare administration. Unlike standard provider credentialing—which focuses mainly
Choosing the right DME credentialing company is one of the most important decisions a durable medical equipment supplier will make.
Running a durable medical equipment (DME) business is already operationally complex: inventory, delivery, documentation, and patient support all demand time
Cardiology billing and coding is one of the most specialized and detail-heavy areas of medical reimbursement. Between complex cardiac diagnostics,
Outsourcing medical billing has become increasingly common across healthcare, but the specialty in which outsourcing generates the highest measurable impact
Below is a detailed breakdown of the responsibilities and specialized tasks cardiology billing experts handle daily. 1. Manage Cardiology-Specific Coding
Cardiology practices in New York face a uniquely complex billing environment — multiple payer types (Medicare, Medicare Advantage, Medicaid MCOs,
Navigating cardiology billing in New York is complex: practices must juggle multiple payers — state Medicaid managed care organizations, Medicare
Cardiology practices in New York operate within one of the most challenging reimbursement environments in the country. High Medicare Advantage
Cardiology practices across New York face some of the most complex billing environments in the country. Between Medicare Advantage penetration,
Cardiology practices manage some of the most complex billing and coding workflows in healthcare. With intricate procedure combinations, frequent imaging,
Cardiology practices face some of the most complex billing and coding requirements in healthcare. Between diagnostic testing, interventional procedures, electrophysiology
Cardiology billing is one of the most technically demanding areas of medical revenue cycle management. With multi-step diagnostic workflows, complex
Small cardiology practices face unique challenges when managing their billing and revenue cycle. Unlike large groups with multiple coders, in-house
Cardiology practices operate in one of the most complex billing environments in healthcare. They must navigate multi-step diagnostic workflows, invasive
Cardiology billing is one of the most complex areas of medical revenue cycle management. The specialty involves a large volume
Electronic claim submission is now the standard across Medicare, Medicaid, and commercial payers. For cardiology practices, however, electronic workflows require
This cheat sheet is for physicians, coders, and practice managers working in cardiology. It focuses on patterns, not every single
Cardiology revenue cycles face some of the highest denial rates in outpatient medicine due to complex procedural rules, multi-component diagnostics,
Correct modifier usage is one of the most important elements of cardiology billing. Misuse of modifiers—especially 25, 59, 58, 78,
Global periods define whether post-procedure services are bundled or separately payable. Cardiology is one of the most complex specialties in
Pacemaker procedures remain among the most highly audited and frequently misunderstood services in cardiology billing. They involve multiple CPT codes,
Cardioversion—whether electrical or chemical—is a common but highly scrutinized service in cardiology billing. Even though the procedure codes appear straightforward,
Three-dimensional (3D) cardiac mapping has become a foundational component of modern electrophysiology (EP) procedures. These technologies—such as CARTO, EnSite, Rhythmia,
Electrophysiology (EP) studies are highly detailed diagnostic procedures used to evaluate arrhythmias, conduction disorders, syncope, wide-complex tachycardia, pre-excitation, and other
Atrial fibrillation (AF) ablation—CPT 93656—is one of the most complex electrophysiology (EP) procedures in cardiology coding. Because AF ablation bundles
Staged percutaneous coronary intervention (PCI) is common in interventional cardiology, especially when patients present with multivessel coronary artery disease or
Percutaneous coronary intervention (PCI) is one of the most heavily audited areas of cardiovascular medicine due to high reimbursement value,
Cardiac catheterization remains one of the highest-audited and most misunderstood billing domains in cardiology. Correctly selecting the right CPT code
Cardiac PET/CT hybrid imaging has become a core diagnostic modality for evaluating myocardial perfusion, coronary flow reserve (CFR), viability, inflammation,