Your Easy Guide to Healthcare Billing and Medicare Updates

Medicare Advantage has been at a critical crossroad. By January 1, 2026, the three-year transition to the new version 28 (V28) of the CMS Hierarchy Condition Category model version 24 (V24) is done. umbers 100% of risk adjusted payment are currently computed under the V28 model only, and not on any other payment year than 2026.

Patient care is a time-constrained dimension. In most services of medical billing, the degree of reimbursement directly correlates to the amount of time spent by a physician or skilled health professional.

Have you ever filed a clean claim and had it rejected weeks after with some kind of reason that did not make sense? Calculation of units is one of the most common, but confusing reasons behind claims denials. You may believe that it is easy to bill a single vial of a drug.

Pharmaceutical identification is entering a major revolution in its landscape. In March 2026, the Food and Drug Administration (FDA) published a final rule that will eventually bring the format of the National Drug Code (NDC) into harmony.

Nutritional counseling has ceased to be an extremity of wellness to become the core aspect of prevention medicine and chronic illnesses. With the recent transition to value based care in healthcare, the services that are coded under dietary and nutrition counseling have been extremely important as sources of revenue to practices.

In the complex system of medical billing, precision is what lies between a clean claim and an expensive denial. There are not many aspects of the surgical coding that depict this fact more than the bilateral procedures.

Denial codes in medical billing can have a considerable effect on revenue and efficiency of the workflow. The CO-16 Denial Code is one of the denials that billing staff has to face. This code is important to understand in order to reimburse on time and to have a smooth revenue cycle.

Type 2 diabetes is one of the most prevalent chronic diseases that is treated in the health sector today. To the medical coders and billers, proper diagnosis coding of this condition will have direct consequences to reimbursement, risk adjustment scores and adherence to payer policies.

Proper reimbursement requires proper documentation of therapy. Unfinished notes tend to lead to refusal or late payment. This is the reason why the proper utilization of 97110 CPT Code is essential.