Insights

Knowledge for a Healthier Practice

Articles, guides, and updates from the EMBS team. New posts coming soon.

Medical Billing Tips

Best Practices for Medical Billing

  • Verify insurance eligibility before every visit to reduce claim denials.
  • Collect accurate patient and insurance information at check-in.
  • Submit claims promptly to avoid missed filing deadlines and payment delays.
  • Ensure documentation supports all billed services for compliance and reimbursement.
  • Analyze denials regularly and correct recurring issues to improve claim acceptance rates.
  • Monitor accounts receivable and follow up on outstanding claims consistently.
  • Stay current with coding updates and payer requirements.
  • Communicate patient financial responsibilities upfront to improve collections and reduce billing disputes.

Compliance Updates

2026 Compliance Updates

  • Enhanced prior authorization requirements and electronic submission standards.
  • Increased payer scrutiny of medical necessity, modifiers, and documentation.
  • Annual CPT, ICD-10, and HCPCS code updates affecting reimbursement and claim accuracy.
  • Expanded interoperability and data-sharing requirements across healthcare systems.
  • More transparent denial reporting and appeals processes from Medicare Advantage and other payers.
  • Ongoing audits focused on documentation integrity, coding accuracy, and billing compliance.
  • Strengthened HIPAA and patient data security expectations as healthcare technology evolves.

Industry News

Key developments in 2026:

  • Payer denials and reimbursement pressure are among the top financial concerns for healthcare organizations.
  • AI and automation are becoming major investments in revenue cycle management, with many organizations using them to reduce manual work and improve claim accuracy.
  • The 2026 CPT code set includes new codes related to AI-assisted healthcare services and digital health technologies.
  • Patient experience has become a top priority for revenue cycle leaders, surpassing revenue growth in some industry surveys.
  • Medicare reimbursement and regulatory changes continue to impact provider revenue and billing operations.