Tag: Medical Billing

Financial Performance

Driving Financial Performance and Operational Efficiency in RCM

The U.S. healthcare ecosystem continues to evolve with each passing quarter. As we navigate through rising operational costs, reimbursement challenges, and digital disruption, healthcare organizations—hospitals, physician groups, and medical billing companies alike—are seeking smarter, more resilient ways to operate and enhance their financial performance. At Allzone Management Services, we’ve had the privilege of partnering with […]
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Electronic Claims Management

Electronic Claims Management: Overcoming ERA and PA Challenges

The U.S. healthcare industry continues its digital transformation, with providers and payers embracing electronic transactions to streamline revenue cycle management (RCM) processes. According to the CAQH Index, adoption of electronic claims management transactions—such as eligibility verification, claim submissions, and claim status inquiries—has reached or surpassed 80% for many transaction types. However, significant gaps remain in […]
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ICD code updates

ICD-10-CM Code Updates: New, Revised & Deleted Codes You Need to Know

For the 2026 ICD-10-CM code updates, you’ll find 16 new “R” codes that offer greater detail for reporting pain and tenderness in the pelvic, perineal, subpubic, abdominal, and flank regions. The existing code R10.2- (Pelvic and perineal pain) will become a parent code. A notable addition is R11.16 (Cannabis hyperemesis syndrome (CHS)), specifically for nausea […]
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MIPS Penalties

MIPS Penalties Hit Small Practices Harder – RCM Solutions Key

When it comes to the Merit-based Incentive Payment System (MIPS), 2025 data reveals a striking disparity: small and rural medical practices were disproportionately penalized, facing significantly higher penalties than their larger, urban counterparts. While the vast majority of MIPS-eligible clinicians (86%) successfully avoided penalties this year, based on their 2023 data, those who did incur […]
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Prior Authorization Automation

Can Automation Solve the Prior Authorization Problem in Healthcare?

In today’s healthcare ecosystem, prior authorization (PA) remains one of the most burdensome administrative processes, creating delays, denials, and dissatisfaction among providers and patients alike. Originally designed to ensure appropriate care and control costs, the process has become a major pain point due to its manual, repetitive, and inconsistent nature. But with the rise of […]
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Medical coding strategies

Top Medical Coding Strategies to Maximize Reimbursements

The difference between a thriving medical facility and one struggling with cash flow often lies in the precision and strategic application of its coding processes. Maximizing reimbursements and strengthening financial health hinges on a proactive approach to medical coding – one that goes beyond simply assigning codes and delves into optimizing every facet of the […]
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proper medical coding practices

Why Proper Medical Coding is Critical for Your Physician Practice

For physicians, understanding and implementing proper medical coding practices isn’t just about administrative efficiency; it’s the lifeblood of your practice, directly impacting reimbursement, compliance, and ultimately, your financial health. Ignoring or mismanaging medical coding can lead to a cascade of problems: denied claims, delayed payments, audits, and even legal repercussions. On the other hand, mastering […]
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