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

Preparing for CLFS Reimbursement Changes: Why...

Laboratory revenue cycle management encompasses every operational process connecting clinical laboratory services to collected Medicare reimbursement – and in August 2026, it has become the most actionable lever available to laboratory executives preparing for a confirmed payment shift. The Consolidated Appropriations Act, 2026, signed February 3, 2026, delayed all PAMA-related Clinical Laboratory Fee Schedule (CLFS) rate reductions through December 31, 2026 – the seventh Congressional intervention since PAMA was enacted [1]. But the reprieve is temporary.

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Laboratory revenue cycle management review of billing accuracy, denials, reimbursement trends, and 2027 CLFS readiness
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documentation to code integrity medical coding services audit exposure 2026 CMS improper payments U.S. healthcare providers specialty
September 10, 2026

Most Healthcare Audit Exposure Doesn'...

Most of what gets called a coding problem is not a coding problem. It is a documentation problem that surfaces in the co...

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physician billing services 2026 Medicare physician fee schedule conversion
July 22, 2026

The 2026 Medicare Physician Fee Sched...

CMS finalized the 2026 Medicare Physician Fee Schedule (MPFS) in October 2025, with policies effective January 1, 2026. ...

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medical coding audit
May 22, 2026

Why Your 99214 Keeps Becoming a 99213...

You’re leaving $25-$40 per visit on the table every time a legitimate 99214 gets downcoded to 99213. Not because someone...

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Pathology Billing
August 12, 2025

The Pathologist's RCM Checklist: Are ...

Your pathologists are diagnosing cancer. But your billing team? They’re diagnosing something else entirely: denials, und...

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Medical Coding Audit
July 08, 2025

Medical Coding Audits 101: How Physic...

You’re wrapping up a 10-hour shift. One more note to finish, one last patient to call – and then someone from billing wa...

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Outsourced Medical Billing in 2025
May 23, 2025

Outsourced Medical Billing in 2025: A...

The medical billing outsourcing market is experiencing unprecedented growth, with the global market size projected to re...

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Market-based logistics efficiency
September 12, 2023

Changed Your Service Lines? It's Time...

In the wake of COVID, budget crunches, and labor shortages, many hospitals and health systems have been making the smart...

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Market-based logistics efficiency
March 07, 2023

Biggest Risks in Physician Billing in...

Physician billing companies know a secret – keeping on top of risks in physician billing services is one of the most eff...

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Market-based logistics efficiency
November 24, 2020

Get Your Billing and Coding Ready for...

Next year promises interesting changes for the Medicare Physician Fee Schedule — many of which will help medical billers...

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