Insights
Practical guides for healthcare revenue and coding teams
Straightforward advice on revenue cycle operations, medical coding, denials and A/R, and risk adjustment.
- How to reduce claim denials: a practical guideA practical, step-by-step guide to reducing claim denials: track the reasons, fix root causes upstream, work appeals on time and measure what changes.
- In-house vs outsourced medical coding: how to decideIn-house vs outsourced medical coding compared on cost, control, quality, capacity and compliance, plus when a hybrid model makes sense.
- RADV audit preparation checklist for Medicare Advantage plansA practical RADV audit preparation checklist for Medicare Advantage plans: what CMS is auditing now, and how to get records, coding review and submission ready.
- How to choose an RCM partner: 10 things to evaluateChoosing a revenue cycle management partner? Compare vendors on 10 criteria, with the questions to ask, red flags to watch for and a free weighted scorecard.
- Top denial reason codes (CARC) and how to fix each oneA practical reference to the most common Claim Adjustment Reason Codes (CARCs): what each one means, why it happens, how to fix the claim and how to prevent it.