Medical Billers and Coders

The 16-day RPM rule is becoming less of a revenue barrier for OBGYNs due to regulatory clarifications, improved device compliance, and better billing workflows. Previously, the requirement that remote patient monitoring (RPM) devices collect data for at least 16 days per 30-day period limited reimbursement opportunities. For OBGYN practices managing pregnancy-related monitoring and chronic maternal conditions, this rule often restricted consistent RPM reimbursement . Recent operational adjustments and clearer CMS guidance are changing how practices approach RPM billing for OBGYNs . What Is the 16-Day RPM Rule? The 16-day RPM rule requires that patient monitoring devices record and transmit data for at least 16 days within 30 days to qualify for monthly RPM reimbursement. This rule was designed to ensure consistent patient engagement, but it created challenges in: Short-term pregnancy monitoring Intermittent blood pressure tracking Gestational diabetes management Post...

Strict collection policies influence ASC valuation by directly improving cash flow, reducing bad debt, strengthening EBITDA, and increasing overall financial predictability. For Ambulatory Surgery Centers (ASCs), valuation is heavily tied to revenue integrity, accounts receivable performance, and clean financial reporting. Weak collection processes create revenue leakage, while structured and disciplined policies increase buyer confidence and enterprise value. In private equity and acquisition environments, predictable collections equal higher multiples. Why Do Collection Policies Matter in ASC Financial Performance? ASC valuation is closely tied to revenue cycle strength. When collection policies are inconsistent, centers experience: High patient balances Extended accounts receivable cycles Increased write-offs Reduced operating margins Strict ASC collection policies ensure timely payment collection, improve liquidity, and stabilize revenue streams. How Do Stri...

Prior authorizations in dermatology are becoming more complex, more restrictive, and more time-consuming, leading to increased claim delays and revenue disruption. As biologics, specialty drugs, and advanced dermatologic procedures become more common, payers are tightening approval requirements. This shift is directly affecting dermatology billing , reimbursement timelines, and administrative workload. Understanding the current landscape is critical for protecting practice revenue. Why Are Prior Authorizations Increasing in Dermatology? The rise in prior authorizations in dermatology is largely driven by high-cost biologics and specialty treatments. Key factors include: Expensive biologic therapies Step therapy requirements Formulary restrictions Increased payer cost control strategies Because dermatology treatments often involve long-term therapy, payers apply strict review standards before approving coverage. How Are Prior Authorizations Impacting Dermatology ...

Precise lesion measurements directly impact dermatology revenue because coding, reimbursement levels, and medical necessity depend on accurate documentation of lesion size and complexity. In dermatology, even small  measurement differences can change procedure codes, alter reimbursement amounts, and trigger  claim denials  if the  documentation does not support the billed service. Accurate measurement is not just a clinical detail—it is a financial safeguard. Why Are Lesion Measurements Critical in Dermatology Billing? In dermatology billing , many procedure codes are selected based on lesion size. Excision, destruction, and biopsy codes often depend on the lesion's diameter, including its margins. Incorrect or incomplete measurements can result in: Downcoding Underpayment Overbilling risks Increased audit exposure Precise measurement ensures proper revenue capture . How Do Coding Guidelines Depend on Lesion Size? CPT coding for lesion removal...

Digital monitoring can be integrated into internal medicine billing by using accurate coding, proper documentation, time tracking, and compliant revenue cycle processes. As internal medicine practices increasingly adopt remote patient monitoring (RPM) and digital health tools, billing processes must evolve to ensure correct reimbursement while avoiding claim denials and payment delays . When integrated properly, digital monitoring in internal medicine billing improves patient care and creates a new, sustainable revenue stream. What Is Digital Monitoring in Internal Medicine? Digital monitoring refers to the use of remote patient monitoring (RPM), wearable devices, mobile health apps, and virtual care platforms to track patient health data outside traditional office visits. Common services include: Blood pressure monitoring Glucose monitoring Cardiac rhythm tracking Chronic condition management through connected devices These services must be properly documented ...

Dermatology biologic claims are facing increased denials in 2026 due to stricter payer policies, prior authorization requirements, documentation scrutiny, and evolving reimbursement guidelines. Biologic therapies are high-cost treatments commonly used for psoriasis, eczema, and other chronic dermatologic conditions. Because of their expense and long-term use, payers are applying tighter review processes, leading to more frequent claim denials and payment delays . Understanding these trends is essential for protecting revenue in dermatology practices. What Is Driving Higher Denials for Dermatology Biologic Claims? Several factors are contributing to rising dermatology biologic claim denials in 2026. Key drivers include: Stricter prior authorization policies Step therapy enforcement Limited formulary coverage Increased medical necessity documentation requirements Frequent policy updates by commercial payers Failure to meet any of these requirements often results...