NCDS Medical Billing

10/14/2026

🧐 Fact or Myth?

"An improper Medicare payment automatically means fraud occurred."

🚫 Myth.

CMS specifically notes that improper payments are not a measure of fraud.

They can include overpayments, underpayments, administrative errors, or situations where there wasn't enough information to determine whether the payment was proper.

Accuracy and documentation matter—but an improper payment and fraud are not the same thing.

Source: CMS FY 2025 Improper Payments Fact Sheet

10/12/2026

💡 Tip of the Day: Don't Just Track A/R—Segment It

A total A/R number only tells part of the story.

Break your accounts receivable down by:
📅 Aging bucket
🏥 Payer
🧾 Service type
⚠️ Outstanding issue

This can make it much easier to identify where reimbursement is slowing down instead of treating every unpaid claim the same way.

Better visibility leads to better follow-up.

10/09/2026

💡 Did You Know?

Electronic payments can do more than eliminate paper checks.

CMS notes that pairing Electronic Funds Transfer (EFT) with Electronic Remittance Advice (ERA) can help:

⚡ Speed up the revenue cycle
⚙️ Streamline manual processes
📋 Support automatic payment posting to A/R

Sometimes revenue cycle efficiency isn't about changing what you bill—it's about improving how payments are processed.

Source: Centers for Medicare & Medicaid Services (CMS)

10/07/2026

📊 Stat of the Day

Prior authorization continues to consume significant time inside medical practices.

According to the AMA's latest survey, physicians and their staff spend an average of 13 hours per physician, per week completing prior authorization requirements. ⏱️

That's time that could otherwise support patient care and other critical practice operations.

Source: American Medical Association, 2026 Prior Authorization Physician Survey

10/05/2026

⏳ Credentialing delays cost more than delayed claims.

A new provider can be trained, licensed, and ready to see patients—but if payer enrollment isn't complete, their ability to deliver reimbursable care may still be limited.

And the impact can ripple across the entire practice:

📅 Scheduling restrictions
👥 Reduced patient access
💰 Delayed revenue generation
📋 More administrative work
📉 Lower provider productivity

In our latest article, we explore the hidden operational costs of slow credentialing and the processes practices can put in place to get providers fully productive sooner.

Because faster credentialing doesn't just mean faster reimbursement—it can mean faster growth.

🔗 Read the full article:https://www.ncdsinc.com/credentialing-delays-and-their-hidden-impact-on-provider-productivity/

Learn how credentialing delays affect provider productivity, scheduling, patient access, billing, and revenue—and how practices can prevent them.

10/01/2026

🚨 Coding Reminder: New ICD-10-CM Codes Are Now in Effect

October 1 marks an important date for medical coding teams.

The FY 2027 ICD-10-CM code set is now effective for patient encounters through September 30, 2027.

Now is a good time to make sure your:
✅ Coding resources are updated
✅ Billing systems reflect the new code set
✅ Staff understands relevant changes
✅ Workflows aren't relying on outdated codes

A new fiscal year means a fresh reason to double-check your coding processes.

Source: CMS & CDC

09/30/2026

💡 Did You Know?

One of the easiest ways to improve billing performance is simply measuring it consistently. 📈

Tracking key metrics each month helps identify trends before they become costly problems—and allows practices to make informed operational decisions.

What gets measured gets improved.

09/28/2026

🧐 Fact or Myth?

"Revenue cycle performance only affects the finance department."

🚫 Myth.

A healthy revenue cycle impacts every part of a practice—from provider productivity and staffing to patient satisfaction and long-term growth.

Financial performance is an organizational effort.

09/25/2026

📣 The Latest Issue of The Revenue Cycle Brief Is Live!

A clean claim doesn't start when the billing team submits it.

It starts much earlier—with eligibility verification. 🔍

In the latest issue of The Revenue Cycle Brief, NCDS President Mick Polo explores why simply confirming active coverage isn't enough—and how small front-end issues can quickly become bigger revenue cycle problems.

Mick covers:
✅ What practices should verify beyond active coverage
✅ Why verification before the visit matters
✅ How eligibility impacts both reimbursement and patient experience
✅ Why recurring eligibility denials often point to a deeper process issue

The takeaway? Don't wait for a denial to tell you something went wrong at registration.

📖 Read Mick's latest issue: https://www.linkedin.com/pulse/issue-3-eligibility-verification-first-step-toward-clean-mick-polo-9sebe

When a claim is denied, it's natural to focus on what happened during billing. Was the claim coded correctly? Was the right information submitted? Did the payer process it correctly? Those are important questions.

09/23/2026

💡 Practices that use automated eligibility verification experience significantly fewer registration-related claim denials than those relying solely on manual processes.

Automating repetitive tasks allows staff to spend more time resolving exceptions instead of routine verifications.

Source: CAQH Index