The Math of a Profitable Practice
By Dr. Heather Signorelli, DO, board-certified pathologist and founder of NatRevMD. Quick answer: A practice turns a profit once each physician sees enough patients to cover their share of overhead and their own pay. In our example, a physician with $480,000 of overhead, $250,000 in compensation and $140 left per visit after supplies needs about […]
Cigna’s Downcoding Policy (R49): What Denial Code C150 Means for Your Practice
By Dr. Heather Signorelli, DO, board-certified pathologist and founder of NatRevMD. Quick answer: CO-150 is the claim adjustment code a payer uses when it decides your documentation does not support the level of service you billed. Under its R49 policy, Cigna uses it to pay a lower E/M level than you submitted. The “CO” means […]
Why Aren’t My Patients Paying Their Balances—and How Can I Fix It?
If you feel like your practice is constantly leaving money on the table, you’re not alone. For many private practices, unpaid patient balances amount to tens of thousands of dollars each year. Unlike insurance reimbursements, which are adjusted before you’re paid, patient dollars are real dollars owed to your practice. The problem is clear: patients […]
5 Myths About Switching Billing Teams
Quick answer: Switching billing teams does not have to hurt your revenue. Insurance payments usually lag 20 to 45 days, so first-month deposits mostly come from claims sent before the switch. The real risk is old A/R that nobody worked. That’s why a good transition starts with a backlog plan that tackles high-dollar and timely-filing […]
CPT 20610: Description, Modifiers, and Bundling Rules
By Dr. Heather Signorelli, DO, board-certified pathologist and founder of NatRevMD. Quick answer CPT 20610 is arthrocentesis, aspiration, or injection of a major joint or bursa (shoulder, hip, knee, or subacromial bursa) without ultrasound guidance. NCCI edits bundle it with knee arthroscopy codes 29870–29881. Bill 20610 separately only when the injection is in a different […]
Should Your Medical Practice Drop Insurance?
Quick answer: Drop insurance only if your numbers support it. First, look at your payer mix, revenue at risk, and your cost per visit compared with what each payer pays. However, many practices can make insurance profitable with clean claims and strong denial work. So consider starting small, such as dropping your lowest-performing payer or […]
The Large Practice Revenue Optimization Guide: 5 Proven Strategies to Increase Collections and Cut Billing Costs
Quick answer: Large practices can raise collections and cut billing costs by focusing on five areas. First, find the true cost of in-house billing, which is often 8 to 15% of collections, not 4 to 6%. Next, prevent denials before they happen, review compliance often, and consider outsourcing. Finally, track key numbers like net collection […]
Top 5 OB/GYN Billing Mistakes (And How to Avoid Them)
By Dr. Heather Signorelli, DO, board-certified pathologist and founder of NatRevMD. Quick answer: The five OB/GYN billing mistakes we see most are billing the full global package after a mid-pregnancy transfer, billing a problem E/M at routine OB visits without modifier 25 and separate notes, missing modifiers on same-day procedures, skipping device and supply codes, […]
Understanding and Optimizing Your Practice Revenue
Quick answer: Practice revenue rarely slows down for one reason. Instead, several processes usually work against each other, such as front desk workflows, provider documentation, outdated fee schedules, and credentialing gaps. To improve revenue, find where money leaks out, fix those workflows, and teach your team why each step matters. That way, the gains last. […]
5 Ways Medical Billing Outsourcing Can Transform Your Practice’s Revenue
Quick answer: Outsourcing medical billing can raise collections through expert coding checks, active denial work, and steady claim follow-up. It also removes in-house billing costs like staff pay, training, and software. In addition, a good partner keeps you current on coding and payer rules and gives you clear reports. As a result, you get more […]