The honest math behind one of the biggest financial decisions a behavioral health practice makes — including the costs that never show up on the spreadsheet. Ask most practice owners what their in-house billing costs, and they’ll point to one number: the biller’s salary. It’s the wrong number — or at least, it’s only the […]
The AMA changed 418 codes this year. Here’s what actually matters for behavioral health, SUD, and mental health providers — and how to keep the changes from costing you money. Every January, the medical billing world quietly resets. The American Medical Association updates its CPT code set — the standardized codes that tell payers exactly […]
A practical guide for behavioral health and medical practices that are tired of watching revenue disappear into denied claims. Every denied claim is money you already earned, sitting just out of reach. You delivered the service. Your team did the work. And then a payer kicks the claim back over something that, in most cases, […]
A practical guide for psychiatric rehabilitation programs — including the January 2026 referral rule that’s now causing claim denials. If you run a psychiatric rehabilitation program in Maryland, your billing just got more complicated. As of January 1, 2026, Maryland Medicaid will deny every PRP claim where the referring provider isn’t actively enrolled. If your […]
The COVID-19 pandemic has had a massive impact on all aspects of daily life, safety, and financial and emotional well being. The impact of COVID-19 on medical billing is significant as well as you must now adjust to new billing and payment tracking updates while striving to continue to provide stellar service to your patients. […]
What is the difference between denied claims and rejected claims? Denied claims are claims that were received and processed by the payer and deemed unpayable. A rejected claim is a claim that contains errors found before the claim was processed. The medical biller’s goal is to make sure the provider is reimbursed for their services. […]
According to a 2019 Healthcare & Business Technology report concerning medical billing, nearly $125 billion in medical revenue is not collected by medical offices each year. Many aspects of healthcare reform and the failure to stay up to date on billing rules and regulations in addition to billing errors can cause revenue losses for healthcare […]
If you pay even the slightest attention to the news you know that medical practices have become a huge target for criminal computer hackers. You also probably know about the potential negative impact that a data breach could have on your medical practice, including loss of money, time, and most importantly loss of trust that […]
While there have been all kinds of advancements and efficiencies in patient care in the medical field, the barriers to running a successful medical practice have increased dramatically. Every medical practice is constantly faced by a near continuous onslaught of challenges that limit its ability to serve the medical needs of its patients. Provider credentialing […]