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Showing posts from November, 2025

Why Revenue Cycle Management Is Essential for Every Medical & Dental Practices

In today’s healthcare environment, strong  Revenue Cycle Management (RCM)  is one of the most important factors that determine the financial success of a medical practice. RCM is more than billing—it is the complete process of tracking a patient’s journey from scheduling to final payment. When managed properly, it improves cash flow, reduces claim denials, and increases overall revenue. The RCM process begins with  patient registration ,  insurance verification , and  eligibility checks . These early steps ensure that the provider captures accurate information and avoids delays in reimbursement. Many claim denials occur because of incorrect demographics or invalid insurance details, so a strong front-end workflow is essential. Next comes  medical coding  and  charge capture . Providers must document accurately so coders can apply the correct  CPT ,  ICD-10 , and  HCPCS  codes. Proper documentation helps prevent audits, underpay...

Why A/R Cleanup Is Critical for Mental Health & Behavioral Health Practices

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Mental and behavioral health providers work tirelessly to support their patients, but behind the scenes, many practices face a growing challenge: aging accounts receivable (A/R) . Because mental and behavioral health billing involves unique payer requirements, strict documentation rules, and specialized codes, a structured A/R Cleanup process is critical to protecting your revenue and ensuring timely reimbursement. Unique A/R Challenges in Mental & Behavioral Health Mental and behavioral health billing is more intricate than standard medical billing. Providers often encounter issues such as: Coding and modifier errors for therapy, counseling, and medication management (e.g., 90791, 90834, 90837, 95/GT modifiers) Missing documentation for treatment plans or progress notes Medical necessity denials are common in mental & behavioral health Authorization requirements for psychiatric and medication management services Coverage gaps as mental & behavioral health pa...

How Clean Claims Improve Revenue for Medical & Behavioral Health Practices

 A healthy revenue cycle starts long before a claim is submitted. For medical and behavioral health providers, clean claims are the key to predictable cash flow, faster reimbursements, and fewer administrative headaches. Yet many practices still struggle with avoidable errors that delay or reduce payments. The good news? A few simple improvements can transform the entire billing process. Clean claims are claims submitted correctly the first time - complete, accurate, and free of coding or documentation errors. When claims meet payer requirements on first submission, practices reduce denials, shorten the payment timeline, and minimize rework. Even a 5-10% increase in clean claim rate can significantly improve monthly revenue. One of the biggest issues providers face is inconsistent documentation. Missing details - such as session length, diagnosis codes, or required modifiers - can trigger denials. Behavioral health practices are especially vulnerable because payers closely review...