Better Practice Solutions, LLC

05/29/2026

Prior authorization requirements are tightening across commercial and Medicare Advantage plans. HealthSpring announced changes effective July 1, 2026. The CMS prior authorization rule now requires specific clinical rationale on all denials — not generic codes — and decisions within 7 calendar days. Practices that aren't building prior auth verification into their workflow now will be managing the fallout in Q3.

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05/27/2026

The June newsletter goes out to subscribers on June 1. If you're not on the list, you're getting this information after the fact. We don't preview the content here — subscribers get it first. If you've been meaning to subscribe, now is the time. Link in bio.

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05/25/2026

05/19/2026

A practice running at 92% net collections looks healthy on paper. But behind that number: a billing team working through lunch, verification calls taking 45 minutes each, and denials being worked manually one by one. Strong collections maintained through unsustainable effort isn't a billing success — it's a staffing problem waiting to happen. Collections follow systems, not effort.

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05/14/2026

If your Q1 collections didn't match your production numbers, that gap has a reason. Moving from a 92% to 97% net collection rate generates more than $60,000 in additional annual revenue for a $1.2M producer — without adding a single new patient. The math is straightforward. The system to get there is where most practices need help.

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05/12/2026

Delta Dental has moved to AI-powered predictive risk scoring to select practices for audit. The trigger is no longer 'unusual billing' — it's algorithmic pattern detection running in real time. Audit initiation is faster. Review cycles are shorter. Clinical decisions are more standardized. If your documentation isn't built to withstand scrutiny, the audit finding will cost more than the claim was worth. Compliance infrastructure protects revenue.

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05/05/2026

The 2026 CDT update introduced 31 new codes, 14 revisions, and 6 deletions. New and revised codes carry higher early denial rates — payer documentation expectations take time to catch up. If your team is still submitting under old code descriptions, claims are coming back. Documentation drives reimbursement.

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04/29/2026

Independent dental practices don't need a large billing company. They need a billing team that knows their practice — the providers, the payers, the patterns. That's what boutique RCM delivers. Direct access, consistent oversight, and someone who picks up the phone when something needs attention.
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04/28/2026

The Improving Dental Administration Act was introduced in March 2026. If passed, it would require self-funded dental plans to comply with more than 360 state insurance reform and patient protection laws — closing a long-standing ERISA loophole. For private practices, this matters. Self-funded plans have operated outside state oversight for decades. This legislation, if enacted, would change the landscape significantly.
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04/21/2026

Next month's newsletter drops on May 1st. If you're not on the list, you're getting this information late — or not at all. Subscribers receive our monthly RCM update before it's referenced anywhere else. It's free, practical, and takes about three minutes to read. Subscribe before the 1st.
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04/14/2026

A practice with steady production noticed collections softening over two quarters. The culprit wasn't denials — it was write-offs being processed as routine without review. Adjustments that should have been appealed were being closed. That pattern, unchecked, compounds quickly across years of claims. Internal write-off review is not optional — it's a revenue control point.



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