Human Medical

10/20/2026

Smooth Billing process makes a world of a difference to your practice

Getting claims through, tracking payments, and following up on unpaid invoices are just three of the many ways we can help

10/20/2026

A claim can still leave money on the table even after it is paid.

When a payer changes a submitted CPT code level that was billed to a lower payable level then the claim will appear complete; however, the payment may need further review.

Your team should consider checking the following:

submit & payed codes
review the ERA or EOB
medical record documentation and payer policy
only file an Appeal if there is supporting documentation for the original billed CPT code level

Regular reviews of claims can help identify potential under payments that would have gone un-noticed by physician practices.

click here for our full Blog post on identifying automatic down coding claims in medical billing👇
https://humanmedicalbilling.com/blog/automatic-downcoding-medical-claims-underpayment/

Automatic downcoding medical claims look paid, not denied. Learn the monthly audit that finds them and where MGMA’s draft bill stands.

10/19/2026

OB/GYN practices: Is your billing workflow ready for January 1, 2027?

The traditional global maternity billing model is changing.

Instead of treating maternity care as one bundled billing process, the new approach separates care into different stages—from antepartum visits to labor, delivery and postpartum care.

That means your team may need to rethink:

How visits are coded
Documentation requirements
Claims workflows
Clearinghouse edits
Staff training

A few months of preparation now could help prevent billing problems later.

Want to see what’s changing? Here’s the full update👇
https://humanmedicalbilling.com/blog/2027-maternity-billing-codes-changes-jan-1/

The 2027 maternity billing codes retire global OB billing for phase-specific codes. See what changes for antepartum, labor, and delivery claims.

10/19/2026

Are Radiology Billing Teams Reviewing Open IDR Cases Prior to Nov.1

The new Federal IDR Batching Rules go into effect in November and it matters how these work.

Qualifying batched disputes that begin their open negotiation period on or after Nov. 1, 2026 will be subject to the following conditions:

- Each batch will consist of no more than 50 line items.
- There will be a 30-business day "cool down" period prior to filing.
- Once the cool down period has passed, the parties will each have only four business days to file.

There are some radiology claims that do not qualify as part of the same batch. Additionally, any case initiated prior to Nov. 1, 2026 may be governed by different requirements.

Here's a summary of the changes and what your staff should check prior to submitting a IDR filing👇
https://humanmedicalbilling.com/blog/federal-idr-november-1-2026-radiology-batching-rules/

Federal IDR November 1 2026 changes hit qualifying radiology disputes. Review the 50 line item cap, cooling-off timing, and Gateway readiness.

10/18/2026

Small billing mistakes can lead to lost revenues. A good billing process should focus on not only submitting accurate claims but also take appropriate actions to get reimbursements for denied and rejected claims, as well as track and follow up on claim status and take corrective measures.

Human Medical Billing is here to help your medical practice manage the billing process to ensure streamlined operations, improved collections and a healthy revenue cycle.

10/17/2026

Are you a cardiologist? Have you reviewed your Medicare diagnosis tables since october 1st?

The centers for Medicare & medicaid services (CMS) have made changes in ICD-10 coding on two cardiovascular procedures, implantable cardioverter defibrillators (icds), as well as cardiac positron emission tomography (PET) perfusion imaging.

Do you have an older version of a diagnosis table in your billing software or electronic health record (EHR)? This could cause additional review requirements on certain claims related to diagnoses.
You do not need to check every claim submitted this year. Identify the specific services that are impacted by these policy updates, cross reference those with the current CMS national coverage determinations (NCD) spreadsheets, and designate any potential denial issues due to diagnostic codes for further review.

Interested in how your staff should handle each step outlined above? Click here👇
https://humanmedicalbilling.com/blog/october-2026-medicare-cardiology-ncd-coding-update/

billing billing coding

This Medicare cardiology NCD update revises ICD and cardiac PET coding tables. See what CMS changed, what it didn’t, and how to check claims.

10/16/2026

Could an outdated ICD-10 code cause your next claim to be denied?

The FY2027 ICD-10-CM changes take effect October 1, with 190 new diagnosis codes, around 30 deleted codes and 4 revisions.

But updating the code list isn't enough.

Your practice should also check:

EHR favorites
Superbills
Prior authorizations
Claim scrubber edits
Practice-management systems

A small system update now could prevent a bigger denial problem later.

Want to know what practices should check before October 1? Here’s the full update👇
https://humanmedicalbilling.com/blog/2027-icd-10-code-changes-billing-team-risks/

The 2027 ICD-10 code changes add 190 codes and delete 30 starting Oct. 1. See the denial risks billing teams face and how to prepare now.

10/16/2026

Getting credentialing right is an important aspect of healthcare practice.

From provider enrollment to ensuring that information is up to date, even the smallest detail can have a major impact on the practice’s ability to function smoothly in relation to payers.

Stay credentialed. Stay prepared to bill. Stay prepared to grow

10/15/2026

Same patient. Same insurance company. Different plan rules? Yes, it can happen.

Medicare open enrollment is set to begin oct. 15, 2026. Coverage changes made by medicare beneficiaries will be in place as of jan. 1, 2027.

If you are a healthcare practice, this means more than just changing the patient's insurance id card. The patient's plan, provider network, need for referrals and requirements regarding prior authorizations may have changed.

Do a couple of things in advance of january so your team won't be wasting their time revising denied claims.

Check the patient's eligibility and exact plan
Check if you are part of the plan's provider network
determine what referrals and/or prior authorizations are required
look at claim denial patterns beginning in early January

here is a practical checklist with the 7 rcm checks your team should Check out today👇
https://humanmedicalbilling.com/blog/medicare-open-enrollment-2027-rcm-checks/

Medicare Open Enrollment 2027 runs Oct. 15 to Dec. 7. Use these 7 RCM checks to prepare your practice for January plan and network changes.

10/14/2026

A prior authorization denial doesn't just create more paperwork. It can affect your entire practice workflow.

The latest OIG findings are drawing attention to concerns around Medicare Advantage prior authorization denials.

For physicians and solo practices, repeated denials can lead to more follow-ups, documentation requests, appeals and delays.

The key is to understand where the gaps are before they become a bigger administrative burden.

Want to learn more? Here’s the link👇
https://humanmedicalbilling.com/blog/oig-report-medicare-advantage-prior-authorization-denials/

New OIG data shows Medicare Advantage prior authorization denials overturned 95% of the time on appeal for SNF admissions. See what billing teams should do next.