Revenue Rx

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

Paid vs Defensible Claim: There is a Difference.

If a claim paid, it must be fine. That belief is one of the most expensive assumptions in healthcare billing. The reality is ...

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When Every Payer Writes Their Own Rules: The Regulatory Interpretation Crisis in Behavioral Health

I want to ask a question that I think every behavioral health provider, compliance officer, and billing director in this coun...

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Psychotherapy Audits

Why 60 Minutes Isn’t Enough: Surprisingly 90837 Fails Audits More Than You Would Expect

If you are billing 90837 the 60-minu...

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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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