2026 CPT Updates: High-Stakes Coding Changes Providers Can’t Afford to Miss

-
Image
  2026 CPT Updates: The High-Stakes Changes Your Providers Might Have Missed The 2026 CPT updates are not just another routine annual refresh. They represent a decisive shift in how healthcare services are documented, coded, reimbursed, and audited. For providers, billers, and healthcare executives, these changes carry real financial and compliance consequences. Missing even a single revision could mean denied claims, underpayments, or worse—an audit that unravels months of revenue. What makes 2026 different is the sheer scope of the changes. The American Medical Association (AMA) has aligned CPT updates more closely with evolving care models, including digital health, value-based reimbursement, and complex chronic care management. In plain terms, the rulebook didn’t just get edited—it got re-written in places. And while many organizations focus on headline changes, the most dangerous updates are often the subtle ones buried in descriptors, time thresholds, and parenthetical note...
Post a Comment

Credentialing For DME Companies

-

 

credentialingfordmecompanies.jpg

Durable Medical Equipment (DME) is equipment that includes oxygen supplies, wheelchairs, iron lungs, catheters, etc. As you are starting a Durable Medical Equipment (DME) company, be prepared with time on hand, money, endurance, and determination; as it ultimately boils down to being paid for the products sold by your company. This means receiving DME bills from clients (patients/healthcare providers) and accepting the insurance, billing the insurance, and finally receiving payments for the DME billing from the insurance provider- is called Credentialing For DME Companies.

DME business also referred to as Home Medical Equipment business is replete with potholes along the way which need to be cleared. One of them is ‘Provider Credentialing.’ Credentialing simply denotes verification. It’s also known as DME credentialing, DME medical credentialing, DME provider enrollment, insurance credentialing, or getting on insurance panels. These terms imply that the patient is going to pay through insurance and your company is “In-Network” with the insurance companies. And, as you go on to be accepted as a provider (post credentialing), receiving payments of DME billing through this process is known as an “In-Network” provider. It also implies acknowledging more clients along with on-time and accurate payments. There are a number of companies through which a DME company can/should be credentialed; government organizations like Medicare, Medicaid, or Tricare, and other big players (commercial insurance) in the market such as Aetna, BCBS, UHC, Cigna, etc. Smaller companies could be targeted too as they have immense potential with respect to a greater number of clients and comprise lesser competition.

To know more about Credentialing For DME Companies, click here: https://bit.ly/3oeJpNS Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

Comments

Post a Comment

Popular posts from this blog

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

-
Image
 Timely reimbursement is the lifeblood of a financially healthy medical practice. Yet, increasing Days in Accounts Receivable (A/R) continues to be one of the most pressing revenue cycle issues for healthcare providers. One of the major culprits behind this issue? Denials. In this blog, we explore how strategic denial management not only reduces days in A/R but also improves cash flow and strengthens your bottom line. Understanding Days in A/R Days in A/R refers to the average number of days it takes for a practice to collect payments due after services have been provided. Industry benchmarks typically suggest keeping A/R days under 35. Anything higher signals inefficiencies - and likely unresolved denials. How Claim Denials Affect A/R Denied claims delay payments and increase administrative burden. Without an effective process to identify, appeal, and correct them, your A/R days will climb - and revenue will suffer. Top causes of denials include: Missing or incorrect ...
Read more

How Outsourced Medical Billing Can Improve Your Practice’s Profitability

-
Image
Managing a medical practice comes with its fair share of challenges—from patient care to staffing and compliance. But one of the most overlooked factors impacting a practice’s financial health is inefficient billing . That’s where outsourced medical billing comes in—not just as a cost-cutting solution, but as a profitability booster . Here’s how outsourcing your medical billing can significantly improve your bottom line. 1. Reduced Administrative Costs Running an in-house billing department requires trained staff, billing software, continual updates, and compliance oversight. These overhead costs can add up quickly. Outsourcing eliminates the need for these expenses, allowing you to pay only for the services you use —often at a fraction of the cost. 2. Faster Claim Submission and Reimbursement Professional billing companies are equipped with experienced teams and advanced tools that ensure quick and accurate claim submission . This minimizes delays and accelerates cash flow , g...
Read more

Understanding the Differences Between Claim Denials and Rejections in Medical Billing

-
Image
In the world of medical billing, two terms often cause confusion for healthcare providers and billing staff alike: claim rejections and claim denials . While both impact revenue and delay reimbursements, they are not the same —and understanding the difference is key to faster, cleaner claim processing. Let’s break it down. What Is a Claim Rejection? A claim rejection occurs when a claim is never accepted into the payer’s adjudication system . It is blocked due to errors or missing information , such as: Incorrect patient demographics Invalid insurance ID numbers Incomplete CPT or ICD-10 codes Formatting errors (especially in EDI files) These claims must be corrected and resubmitted —but the good news is they haven't been officially processed yet, so no appeal is needed . What Is a Claim Denial? A claim denial happens after the payer reviews and processes the claim , then decides not to pay it . Reasons may include: Lack of medical necessity Services n...
Read more