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Latest posts
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Appeals That Actually Win: Beyond Templates to Root-Cause Fixes
When Copy-Paste Appeals Stop Working Two months ago, Jason, the revenue cycle director at a mid‑sized orthopedic practice, noticed a troubling trend. His team was sending appeal letters for denied claims faster than ever, using the same “tried‑and‑true” templates they’d relied on for years. But payer overturn rates were slipping—from 68% to just 41%. The…
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When Clean Claims Go Dirty: The Hidden Errors Sabotaging Your Reimbursements
The Day the Cash Flow Slowed to a Crawl Last summer, Maria, the practice manager of a busy rural cardiology clinic, was feeling confident. The team had just hit a 94% clean-claim submission rate—a figure that meant faster payments and fewer headaches. But by October, things had changed. Reimbursement timelines were stretching, denials were piling…
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The Credentialing Trap: How Delays at the Start Cripple Your Revenue Cycle
Credentialing is often treated as a standalone task—an administrative checklist that simply needs to be completed before a provider can see patients. But this mindset underestimates the far-reaching consequences of getting it wrong. When credentialing delays occur, the impact ripples downstream: denied claims, unbilled visits, and mounting frustration for patients and staff alike. More Than…
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📌 Appeal or Abandon? A Data-Driven Framework for Smart Denial Triage
The Appeal Dilemma Denials are inevitable—but wasted appeals are optional.Many revenue cycle teams treat denials reactively: appeal everything, escalate if denied again, and hope something sticks. This approach is: Not all denials deserve your time. The question isn’t just can you appeal, but should you? Denial Volume ≠ Denial Value Denial rates get attention, but…
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🩺 Time to Talk TAT: Why Turnaround Time Should Be a KPI in Your Revenue Cycle
What Is Turnaround Time — and Why Does It Matter? Turnaround time (TAT) refers to the time it takes for a task or process in the revenue cycle to be completed from start to finish. Whether it’s submitting a claim, receiving a payment, responding to a denial, or obtaining prior authorization — the speed of…
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Template Trouble: How Poor EHR Design Is Killing Clean Claims in 2025
📉 Your EHR Isn’t Helping—It’s Hurting Your Claims EHR templates were designed to streamline workflows, standardize notes, and help providers meet documentation requirements faster. But in 2025, they’ve become a top source of hidden claim contamination. At Thrive, we’ve seen it firsthand: templates meant to speed things up actually introduce patterns that trigger payer audits,…
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The 5 Biggest Pain Points in FQHC Billing—and How to Solve Them
For Federally Qualified Health Centers (FQHCs), billing isn’t just complex—it’s uniquely demanding.Unlike traditional provider organizations, FQHCs face a highly regulated, grant-funded, and payer-diverse environment that introduces billing, compliance, and documentation hurdles at every stage of the revenue cycle. From flat PPS reimbursements to HRSA audit exposure and Medicaid-specific rules, most FQHC billing teams are forced…
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💸 The $100K Denial Problem: Why Medicare Billing Mistakes Are Costing Providers More Than Ever
Unresolved Medicare denials aren’t just an administrative hassle—they’re silent revenue killers. Across the country, providers are leaving tens of thousands—sometimes hundreds of thousands—of dollars on the table each year due to preventable billing and coding errors. What’s worse? Many don’t realize it until it’s too late for appeals or corrections. As a 25-year Medicare RCM…
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Modifier 25 and Medicare Denials: How to Protect Office Visit Revenue in 2025
Medicare denials for office visits are on the rise—and Modifier 25 is one of the biggest culprits. If your practice is experiencing denials for E/M services billed on the same day as procedures, you’re not alone. In 2023, multiple Medicare Administrative Contractors (MACs) ramped up pre-payment edits and post-payment reviews targeting misuse of Modifier 25,…