Revenue Rx

 The prescription for maximizing reimbursement, streamlining operations, and avoiding costly mistakes in healthcare billing.

The Hidden Cost of Being Out of Network

Providers have the right to choose whether they participate in insurance networks. That decision is not reckless, unethical, ...

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Prepayment Review: When Oversight Becomes a Cash-Flow Nightmare

This week, I received three emails from community behavioral health organizations that all said some version of the same thin...

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The Most Dangerous Gap in Behavioral Health Isn’t Clinical It’s Operational

Why Good Behavioral Health Organizations Still End Up at Risk

Most compliance issues I see do not come from negligence or ba...

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Why Payment Posting Is the Most Overlooked Step in Healthcare RCM

In healthcare revenue cycle management, most of the focus goes to eligibility checks, claims submission, and denial follow-up...

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Cigna's E/M Code Adjustment Policy: A Misguided Solution to a Real Problem

The insurance giant's new approach to combating E/M upcoding creates more problems than it solves

Effective October 1, 2025,...

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The Hidden Cost of Copy-Paste in Behavioral Health Documentation

Clinicians are busy. Caseloads are high, appointment times are tight, and documenting in the EHR often takes longer than the ...

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