Your billing manager pulls the aging report on a Friday afternoon. The EMG claims from three weeks ago are still sitting there. Two EEGs came back denied for medical necessity. An infusion claim bounced because the diagnosis code didn't match the one on the authorization. None of these were clinical mistakes. Every one of them was a billing problem.
Ask five people at a practice what revenue cycle management means, and you will likely get five different answers. The front desk thinks it is insurance verification. The billing team thinks it is claims and denials. The physician thinks it is whatever happens after they finish a chart note. All of them are partially right, and that fragmented understanding is exactly why so much revenue disappears between patient visit and deposited payment.
The Importance of Patient Engagement: Why They - And You - Need It
Learn why patient engagement is a necessity and how you can master it within your practice.
Medical Billing / RCM | Genomic Testing | Laboratory
The AMP 2026 Annual Meeting & Expo runs November 10 to 14 in Seattle, with the main program November 12 to 14. The ADS lab team will be in Booth #1901. Molecular lab leaders will spend three days on new assays, sequencing workflows and what comes next in precision diagnostics. The science gets the spotlight. The billing decides whether those tests get paid. If you are heading to Seattle, here are five questions worth bringing with you, and worth answering before your next payer audit.
Medical Billing / RCM | Industry News | Medical Practice | CMS
If your practice bills Medicare, January 1, 2027 is coming with a pay cut attached. In July, CMS released its proposed 2027 Medicare physician fee schedule, and for most physicians the conversion factor drops 1.68%, from $33.40 to $32.84. Qualifying APM participants fare slightly better, with a 1.19% drop to $33.17. Most of the cut comes from the expiration of the one-time 2.5% bump Congress provided for 2026. Small statutory updates of 0.25% and 0.75% do not make up the difference. A 1.68% cut sounds small. For a specialty practice with tight margins, rising costs and a heavy procedure mix, it rarely lands as 1.68%. The question is not whether Medicare reimbursement cuts are coming. It is how much they will cost you, code by code. Want your number now? Estimate your 2027 Medicare impact with our free calculator.
Your lab processed ten thousand claims this month. A few hundred came back denied, not for bad science, but for a documentation gap nobody caught until the remit arrived.
A wound care program had its billing dialed in for years. Debridement codes, skin substitute application, modifier pairing, all of it ran smoothly. Then January 1, 2026 arrived, and the revenue cycle team spent the next month relearning how to bill the exact same clinical work.
A wound care claim comes back denied. The clinician measured correctly, applied the right product, and followed the treatment protocol exactly. But the note describes the wound in words, and the payer's reviewer cannot verify wound depth, tissue type, or healing progression from a paragraph of text. Without a photo, the claim reads as unverifiable, not incorrect.
A patient comes in for a scheduled CGRP infusion, part of an ongoing chronic migraine treatment plan. The clinical visit goes exactly as planned. Three weeks later, the claim comes back denied because the infusion sequencing code and the primary drug code were billed out of order, and the payer's system flagged it as a duplicate rather than a coordinated administration.
Medical Billing / RCM | Laboratory
Molecular diagnostics continues to change what is possible in medicine. Genetic testing, next generation sequencing, biomarker testing and other advanced diagnostics are giving clinicians increasingly sophisticated information to help diagnose disease, guide treatment and support precision medicine.
The final quarter of 2026 is here, and laboratories have plenty to think about before January.