CPT codes are the foundation of medical billing. When it comes to orthopedic and shoulder surgery, CPT code 29806 plays a critical role. This specific code refers to a particular type of shoulder surgery known as arthroscopic shoulder stabilization. If incorrectly applied, CPT 29806 can lead to denied claims, revenue loss, or even compliance issues. […]
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Billing errors can quietly erode your revenue cycle. One mistyped modifier, such as F6, used to identify the right index finger, can delay reimbursements or trigger denials. Suppose your staff miscodes a routine procedure or forgets to include the proper modifier for the right index finger. In that case, that oversight can lead to a
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Modifier 25 seems simple, but it is one of the most commonly misused and heavily audited modifiers in medical billing. Knowing exactly when Modifier 25 is used can mean the difference between a clean claim and one that gets flagged or denied. Misusing this modifier creates unnecessary billing complications, jeopardizes reimbursement, and may raise compliance
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Picture this: a first-time patient schedules an appointment through your website at midnight, checks your clinic’s Google reviews over breakfast, verifies insurance on a mobile app during lunch, and by evening, has received a follow-up text confirming their lab results and co-pay estimate. This is not an ideal future; it is the current reality of
What Is Healthcare Consumerism and How Can Your Practice Keep Up? Read More »
Florida’s Medicaid landscape has shifted dramatically in 2025 with the rollout of the Statewide Medicaid Managed Care (SMMC) 3.0 program by the Agency for Health Care Administration (AHCA). Yet many providers struggle to define managed healthcare in terms that matter to their revenue cycle. Managed care is not simply a payer network; it is a
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Modifier 25 may appear straightforward on the surface, but its misuse can have significant implications for your revenue cycle. Misapplied, this simple two-digit code can trigger claim denials, payer audits, and revenue delays. For healthcare providers navigating the complexities of medical billing in Florida, understanding the proper application of Modifier 25 is essential. This post
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In an era marked by unprecedented technological advancements and shifting healthcare landscapes, the medical field is experiencing a paradigm shift in its operational strategies. One such innovative approach that has gained prominence is shared staffing—a novel ancillary designed to optimize cost savings and leverage economies of scale. This revolutionary concept is transforming the way medical
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If you have been following the IHBS newsletters, you will know IHBS has had Medicare Advantage plans on our radar for sometime. However, if you are new to The Independent Physician, here is a brief history. Medicare Advantage plans hit the market at a tremendous pace. At first glance, they appeared to be similar to
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Providers often enter into agreements with vendors and once these agreements are in place, they are never reviewed again. Unfortunately, this is a common occurrence with pharmaceutical vendors where margins can be slim at best. Over time, the cost of these medications rise and reimbursement either shrinks or stays the same. This leads to diminishing
Know Your Margins Read More »
Insurance contracts are one of the most valuable assets to any medical practice. However, as time goes by, offices put them in a filing cabinet or even misplace them never to be seen again. When we consult for a practice in dire straights, one of the first items we ask to review are the insurance
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