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CMS-1832-F 2026: How Practice Expense Cuts Hit Cardiology
By Sarah Callahan ·
Cardiology just lost its facility-based payment cushion. CMS finalized CMS-1832-F on October 31, 2025, and the rule takes effect January 1, 2026. It rewrites how…
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QPA Benchmark 2026: Surprise Billing Rules for Physicians
By Sarah Callahan ·
What Is the QPA in 2026 Physician Billing? The Qualifying Payment Amount is a health plan’s median contracted rate for a given service, frozen at…
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AI-Augmented CPT Codes 2026: A Physician Billing Playbook
By Danish William ·
The AMA’s 2026 CPT set adds 288 new codes, deletes 84, and revises 46, formally recognizing augmented intelligence as a billable clinical input for the…
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Collecting Patient Balances After Insurance Underpayment
By Danish William ·
The distinction that destroys revenue cycles isn’t a billing error. It’s a misclassification — the silent moment when a payment poster treats an insurer’s $80…
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New Provider Not Credentialed? Why Claims Get Denied Now
By Danish William ·
Picture the scenario. A new nurse practitioner starts Monday. Patients are booked through Friday. Front desk runs eligibility checks, sees an active plan, and the…
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Medicare Advantage 2026 Exits: Claims and Enrollment Gap
By Sarah Callahan ·
The numbers are not ambiguous. Approximately 2.9 million Medicare Advantage enrollees faced forced plan terminations in 2026. That is roughly 10% of all non-employer HMO…
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Peer-to-Peer Review Documentation That Wins More Appeals
By Danish William ·
Most peer-to-peer guidance treats the call as the event. It isn’t. The call is the last five minutes of a documentation process that started days…
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NY Workers Comp 95-Day Filing: Electronic Billing Rules
By Danish William ·
The 95-day rule doesn’t forgive ignorance. It doesn’t accommodate staffing gaps, software migrations, or a billing manager who missed the alert. New York’s Workers’ Compensation…
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No Surprises Act 2026: Updated IDR Eligibility Checklist
By Sarah Callahan ·
As of January 31, 2026, disputing parties have filed over 5.1 million disputes through the federal IDR portal — fourteen times the annual volume CMS…
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Top Texas TMHP Claim Rejection Reasons and How to Fix It
By Sarah Callahan ·
Texas Medicaid providers write off tens of millions of dollars annually not because of clinical failures, but because of preventable claim rejections. The Texas Medicaid…