Why High-Volume Primary Care Clinics Still Struggle with Cash Flow in 2026

Image
Patient volume alone does not guarantee financial success. Many high-volume primary care clinics are seeing more patients than ever in 2026, yet they continue to experience declining cash flow, increasing accounts receivable (AR), and inconsistent monthly collections. Despite busy schedules and full appointment books, reimbursement delays, payer denials, coding errors, and administrative inefficiencies often prevent practices from converting clinical activity into predictable revenue. Today's primary care environment is more complex than ever. Evaluation and Management (E/M) coding updates, Medicare Advantage policies, commercial payer requirements, prior authorization rules, and preventive care reimbursement all contribute to a challenging revenue cycle. This is why many providers are asking: Why do high-volume primary care clinics still struggle with cash flow in 2026? The answer often lies within the billing process. Practices that invest in specialized Primary Care Billing Ser...

Correct Use of Modifiers for Podiatry Services

 

correctuseofmodifiersforpodiatryservices.jpg

Improper use of Modifiers for Podiatry Services can be the cause of claim denials just as not using a modifier can be. When using modifiers, make sure you clearly understand what the modifier entails. Sometimes, there are related services that the physician is performing, global periods to contend with, etc. Modifiers will clarify extenuating circumstances, which should allow for payment when they otherwise may not.

If the insurance company denies a claim and you rebill it by simply choosing another modifier and hoping that is the correct one, this will usually end up creating additional problems. Insurance companies may have a time limit as to how long you can file an appeal. If you continually rebill incorrectly, then by the time you send in the claims and subsequently get denied again, you may run out of the appeal window. The appeal window generally starts when you submit the initial claim. Medicare explanation of medical benefits (EOMBs) will indicate whether you can appeal a claim rather than rebill, depending on the error.

There are three specific evaluation and management (E/M) modifiers. These are the -24, -25, and -57 modifiers. Only use these modifiers with E/M services. If you append them to any other service such as a diagnostic study or procedure, the carrier will automatically deny your claim.

Modifiers for Podiatry Services are:

Modifier 24:

Unrelated Evaluation and Management by the same physician during a postoperative period. When an unrelated E/M service is performed by the same physician during the postoperative (global period -10 or 90-day postoperative period) then append modifier 24 to the E/M procedure code. Make sure that we are not assigning the same diagnosis code which is the reason for the surgery which was performed earlier, and then there would be the chance of the claim getting denied.

To know more about the Correct Use of Modifiers for Podiatry Services, click here: https://bit.ly/3KhgRMc Contact us at info@medicalbillersandcoders.com888-357-3226.

Comments

Popular posts from this blog

How to Reduce Days in A/R with Smart Denial Management Strategies

How Outsourced Medical Billing Can Improve Your Practice’s Profitability

Is Your Neurology Billing Outsourcing Helping or Hurting You at Year-End?