A laboratory receives a denial. Someone investigates it, corrects it, resubmits or appeals it, and eventually gets it paid. Then another claim gets denied for the same reason next month. That is not a billing win. It is expensive repetition. As independent laboratories prepare for 2027, one of the biggest opportunities is not simply working denials faster. It is preventing more of them before they happen.
A total knee replacement doesn't generate one line on a claim. It generates a primary procedure code, an implant HCPCS code, an invoice attachment, and a stack of modifiers deciding whether each line gets paid at all. Miss one piece and the whole claim can come back, not just the piece that was wrong. Orthopedic surgery billing carries more moving parts than almost any other specialty, and the 2026 coding environment has added more.
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.
Your practice already has the patients who need it. You just aren't billing for it. Chronic condition patients call in with blood pressure spikes between visits. Diabetic patients need glucose trend data you don't see until the next appointment. Every one of those touchpoints is billable today, and most practices are walking past the revenue without realizing it's there.
mental health | behavioral health
Your intake coordinator is staring at a consent form, unsure whether the new rules let her share a patient's SUD treatment history with the primary care office down the hall. Your compliance officer is wondering if last year's forms are still valid. If that sounds familiar, you're not behind. You're just catching up to a rule that's been rolling out for two years. And if your program bills per diem or ASAM levels of care, the compliance stakes are even higher -- the payer rules governing inpatient SUD billing intersect directly with how Part 2 records can be used and shared.
Looking to improve your revenue cycle? Visit our Revenue Cycle Management page to see how ADS can help. An MRI order goes in for a patient with a possible demyelinating lesion. A week passes. Then two. The scan still hasn't happened, not because anything is clinically wrong, but because a payer hasn't signed off yet. Your staff is on hold. Your patient is waiting. And the chart just sits there.
A wound care visit ends, and the real work starts. Measurements need logging. Photos need tagging. Debridement notes need to hold up if a payer or an auditor ever looks twice. Your EHR either carries that load with you, or it hands you a template built for a completely different kind of visit and calls it good enough.
mental health | behavioral health
Most behavioral health and addiction treatment organizations do not switch EHRs because they want to. They switch because the general-purpose system they started with cannot keep up with ASAM level-of-care documentation, 42 CFR Part 2 consent rules, or the reporting a payer now demands before it will pay a claim.
mental health | behavioral health
Your clinician finishes a session and spends the next ten minutes reformatting the note to fit a template built for a strep throat visit. The PHQ-9 score from last visit lives in a different tab. The consent form for a patient with a co-occurring substance use disorder is a scanned PDF nobody can find during an audit. None of that shows up in a sales demo.
Looking to improve your revenue cycle? Visit our Revenue Cycle Management page → to see how ADS can help. A denial notice lands in your inbox six weeks after the visit. Nobody on staff remembers the appointment, let alone what went wrong. Your biller pulls the chart and finds a missing referral number from before the patient ever walked in. Now the appeal clock is running, and it's running on a mistake nobody caught until today.
Looking for laboratory billing software or RCM services? Visit our Laboratory Solutions page → to see how ADS supports labs like yours. For the past several months, independent laboratories across the country have been focused on one milestone:the July 31 PAMA reporting deadline. Finance teams gathered private payer data, laboratory leadership reviewed reimbursement information, and billing departments submitted the required reporting to CMS under the Protecting Access to Medicare Act.