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When Should a Medical Practice Consider Outsourcing Medical Billing?

Running a successful medical practice requires more than delivering excellent patient care. Behind every patient visit is a complex revenue cycle involving eligibility verification, coding, claim submission, payment posting, denial management, AR follow-up, and payer communication. When these processes are not managed effectively, revenue can get delayed—or lost altogether. So, when should your medical practice […]

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Old AR Cleanup: Why Aging Claims Over 120 Days Are Still Recoverable

In healthcare revenue cycle management, aging claims are often viewed as “dead AR.” Once claims cross 120 days, many practices stop prioritizing them and shift focus to newer balances. Unfortunately, that mindset can leave thousands — sometimes millions — of dollars uncollected. The truth is: old AR is not always lost revenue. At Total RCM

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Medicare Global Surgery Updates 2026: A Quiet Year That Could Impact Your Revenue

At first glance, 2026 may seem like a quiet year for Medicare global surgery changes. There are no dramatic overhauls or headline-grabbing reforms. But if you look a little closer, it becomes clear—this is not a year to relax. The global surgical package, which bundles pre-operative, intra-operative, and post-operative care into a single payment, remains

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Congress Passes a New Health Package: What Providers and RCM Companies Need to Know.

Congress has passed a FY 2026 “minibus” appropriations package that includes funding for the Department of Health and Human Services (HHS) along with several important healthcare policy updates. While the bill does not extend enhanced ACA premium subsidies, it delivers meaningful changes that directly impact providers, billing teams, and revenue cycle management (RCM) organizations. Rather

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2026 CPT Code Updates: A Comprehensive Guide for Providers and Medical Billing Teams

The 2026 CPT® code set introduces one of the most significant updates in recent years, with extensive changes across multiple specialties. These updates reflect advancements in medical technology, evolving care delivery models, and CMS’s ongoing efforts to improve coding accuracy and reimbursement alignment. For providers, coders, and revenue cycle management (RCM) teams, understanding these changes

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2026 Payer Policy Changes Are Live: What Providers Must Know Now

As 2026 begins, U.S. healthcare providers are operating under a new set of payer and regulatory rules that directly impact reimbursement, coverage eligibility, and revenue cycle workflows. Several Medicare, Medicare Advantage (MA), and ACA Marketplace policies finalized in 2025 took effect on January 1, 2026, making early-year execution critical for financial stability. This blog outlines

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How AI Predicts Payer Denials Before They Happen

Payer denials continue to be one of the biggest revenue challenges for healthcare practices and billing companies. Denied claims slow down reimbursement, increase administrative effort, and reduce financial stability. Traditionally, billing teams identify trends only after denials start piling up — making the process reactive and time-consuming. Today, Artificial Intelligence (AI) is transforming denial management

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Cigna and Medicare Policy Updates You Need to Know Oct 2025

As we enter October, several major payor updates are taking effect that could directly impact how your practice bills and gets reimbursed. Cigna Healthcare – New Reimbursement Policy (R49)Effective October 1, 2025, Cigna Healthcare will implement its new reimbursement policy, Evaluation and Management Coding Accuracy (R49). This policy will review professional claims billed with CPT

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Navigating a U.S. Government Shutdown: Impacts on Healthcare and Revenue Cycle Management

By Total RCM Solutions The U.S. government shutdown that began on October 1, 2025 has triggered uncertainty across the nation. For healthcare, the impact is not always immediate, but the ripple effects—from delayed Medicare payments to telehealth coverage lapses—can place real strain on providers and revenue cycle operations. At Total RCM Solutions LLC, we understand

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