AccuMed Billing Services

05/28/2026

"The solution to the efficiency paradox may lie in moving away from the “submit and wait” model toward real-time adjudication at the point of care. Emerging models, such as the collaboration between Optum Rx and Cleveland Clinic, have shown promising results, including an 88% reduction in appeals and a 68% reduction in denials caused by missing information."

A report from the Peterson Health Technology Institute says efficiency in AI tools is still lacking.

05/26/2026

It's more complicated than ever. "Four major insurers showed almost no overlap in prior authorization requirements and no shared approval criteria or documentation rules, potentially contributing to the time and administrative burden of obtaining treatment approvals, according to a new study published in the Annals of Internal Medicine."

A new study finds that prior authorization requirements vary widely across major insurers and suggests large language models could help streamline how authorization rules are interpreted and processed.

05/22/2026

The team at AccuMed Billing Services monitors trends in reimbursement in Pennsylvania and beyond — so you don't have to. ttps://www.beckersasc.com/asc-coding-billing-and-collections/the-payer-moves-quietly-cutting-reimbursements/

Major payers are quietly cutting reimbursement by automatically adjusting the complexity codes on claims before payment clears. In the past year, Cigna, Aetna, Anthem and BCBS of Massachusetts have all launched or expanded automatic downcoding programs, algorithmically adjusting higher-complexity E/...

05/20/2026

Medical billing and coding just keeps getting more complex ... and tricky. Give our experienced team a call to find out how we can help.

The following is a guest article by Ritesh Ramesh, CEO at MDauditHealthcare organizations are operating in an environment defined by financial pressure, regulatory scrutiny, and rapid shifts in payer behavior.

05/08/2026

"Independent radiation oncology practices across the country are asking commercial payers to make a simple adjustment that maintains budget neutrality and does not increase overall spending. As they have done when reimbursement codes were previously bundled, commercial payers should reprice payment codes to account for the real-world costs that providers bear to deliver more labor-intensive, advanced technologies.
Without this alignment, practices delivering advanced radiation therapy could face substantial reimbursement shortfalls that threaten the sustainability of the services that patients rely on." If your practice is struggling to keep up with coding changes, it's time to consider outsourcing your medical billing. Patient care should be your first priority. Let us handle the paperwork for you.

Treatment delivery codes recently revised by the American Medical Association are putting cancer care at risk by limiting patient access in community settings, argues Todd Doyle, MD.

05/04/2026

"Billing affects more than revenue. Delays or errors can slow care, frustrate patients, and strain staff morale. A denied claim often means follow-up calls, corrected codes, and long waits. Each step pulls attention away from people in the exam room. A 2023 survey from the Medical Group Management Association found that billing tasks rank among the top three sources of staff stress. That stress links to turnover, which then raises hiring and training costs." Need any more reasons to outsource your medical billing to an experienced, accurate team?

  Practice Management · Medical Billing Medical Billing Explained: From Visit to Payment How the billing process works, why it matters to patient access and clinic health, and how practices decide who should handle it. #3 Billing ranks among the top three sources of staff stress (MGMA 2023) 6–9 ...

05/02/2026

When codes change, our experienced medical billing team can make sure your practice is using accurate information. Let's talk about how we can help you avoid errors — and save time and money. https://www.ama-assn.org/practice-management/cpt/cpt-2027-maternity-care-services-code-changes

Find out about changes to the codes for maternity care services, which includes separate codes for antepartum care, labor management, delivery and postpartum care.

04/30/2026

"Effective Jan. 1, 2027, CPT codes will better reflect modern obstetric practice, enable accurate and transparent reporting across the full pregnancy spectrum, and create the data foundation necessary to better attribute maternal care and support the complexities of team-based care throughout a patient's journey." More changes are coming. Is your team keeping up? If you're thinking about outsourcing your medical billing, give AccuMed Billing Services a call. Our team can help. https://www.ama-assn.org/practice-management/cpt/cpt-2027-maternity-care-services-code-changes

Find out about changes to the codes for maternity care services, which includes separate codes for antepartum care, labor management, delivery and postpartum care.

04/28/2026

Have you heard of "downcoding?" Do you know how to protect your revenues from this increasingly common practice? Call the experienced team at AccuMed Billing Services. We stay up to date on payer trends and tactics so you don't have to. https://www.aafp.org/news/blogs/aafp-voices/downcoding-push-back.html

04/26/2026

If your medical billing team is trying to maximize collections with minimal hassle, connect with us at AccuMed Billing Services. We are experienced and effective — and with you every step of the way. Call us to chat about how we can help you save time and collect revenue in a timely way. https://www.healthleadersmedia.com/revenue-cycle/infographic-3-expert-takeaways-rethinking-pre-service-collections