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Insights That Move Healthcare

Expert perspectives on revenue cycle, risk adjustment, compliance, and healthcare strategy – designed to help providers, plans, and leaders make smarter operational and financial decisions.

Modifier 59: Why $4.4 Million in Podiatry Bil...

Podiatry billing services for foot and ankle surgery require a level of modifier precision that standard automated billing systems are not built to deliver – and the consequences of getting it wrong are measurable. OIG's December 2025 audit of podiatrists' Medicare claims found that 49 of 100 sampled claims did not comply with Medicare requirements, projecting approximately $4.4 million in improper payments across the full claim population [1].

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Podiatry coding review for Modifier 59 and XS documentation accuracy in multi-procedure foot and ankle surgery claims
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FQHC billing team reviewing 2026 CMS coding changes, claim performance, and revenue cycle management requirements
September 15, 2026

FQHC Billing and Reimbursement: What ...

FQHC billing services in 2026 are operating under a materially updated payment and coding environment – one that affects...

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orthopedic billing services 2026 revenue leakage denial patterns prior authorization medical billing
September 08, 2026

Orthopedic Revenue Leakage in 2026: T...

In 2026, orthopedic revenue leakage is becoming a growing financial concern for healthcare organizations across the Unit...

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pediatric billing services 2026 CPT codes 90482 90483 90484 vaccine counseling developmental
August 31, 2026

Pediatric Coding Complexity in 2026: ...

In 2026, keeping up with pediatric coding updates has become a top priority for U.S. healthcare organizations. Specializ...

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gastroenterology billing services screening diagnostic colonoscopy conversion modifier PT 2026
August 28, 2026

How Screening-to-Diagnostic Colonosco...

In 2026, screening-to-diagnostic colonoscopy conversions remain one of the most overlooked reimbursement risks for gastr...

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orthopedic billing services PE-backed practice EBITDA revenue cycle medical billing
July 28, 2026

Why Orthopedic Billing Accuracy Is a ...

Orthopedic billing services are the specialized revenue cycle functions that manage claim submission, coding accuracy, p...

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laboratory revenue cycle management clinical lab billing services pathology billing services
July 17, 2026

What the 2026 OIG Lab Spending Data M...

For clinical laboratory and pathology executives, 2026 presents a reimbursement landscape that looks fundamentally diffe...

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outsourcing medical billing services cash flow US healthcare 2026
July 13, 2026

Clean Claim Strategies in 2026: How S...

In 2026, outsourcing medical billing and clean claim strategy are converging into a single financial priority for U.S. h...

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accounts receivable management services healthcare outsourcing AR revenue
July 03, 2026

What to Look for in Accounts Receivab...

The U.S. medical billing outsourcing market – which encompasses accounts receivable management services, coding, claims ...

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CMS TEAM model orthopedic billing services 2026
July 01, 2026

What TEAM Means for Orthopedic Billin...

The CMS Transforming Episode Accountability Model (TEAM) is in play, and its impact on orthopedic billing services will ...

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