For billing professionals, coders, and compliance leaders, this isn’t just a policy issue—it’s a practical one with real consequences in documentation, audits, and reimbursement integrity.
Risk-adjusted payment is no longer just a Medicare Advantage concern—commercial insurers are reshaping how coding, documentation, and compliance strategies must evolve.
From coding and billing errors to practice management missteps, we explore the root causes of revenue leakage and provide practical tools to protect your revenue.
Documentation errors, whether undercoding or overcoding, can make you a target for payers who are becoming more proactive in spotting inconsistencies and recouping payments. A single bad audit can lead to more extensive investigations.
This article outlines the expected modifications and how they may affect billing and clinical reporting for imaging, interventional procedures, and emerging technologies.