Revenue Cycle Management
Prior Authorization, Denials and Payment Articles
Revenue cycle management is the whole financial path of a patient visit: eligibility and authorization before the visit, coding and claim submission after it, then denials, appeals and the patient balance. These articles cover prior authorization, denials, payment posting and patient balances.
Figures are representative averages across our client base; individual results vary by practice, specialty, and payer mix.
Revenue cycle management covers the whole financial life of a patient visit, from scheduling and insurance checks to the final payment. A weak step early on causes problems later, usually as denials or balances nobody follows up.
A denial nobody works is money the practice never collects. Of roughly 85 million in-network claims denied by HealthCare.gov plans in 2024, fewer than 1% were appealed (KFF analysis of CMS data). Checking eligibility before the visit, checking claims before they go out and filing on time all prevent denials.
Track days in accounts receivable, the share of claims paid on first submission and your net collection rate every month. The trend matters more than any single benchmark. Medtransic handles billing, denials and patient balances for therapy and behavioral health practices.
Revenue Cycle Management Articles
Guides on prior authorization, denials, payment posting, patient balances and the stages of the billing cycle.
Medicare Prior Authorization: What Original Medicare and Medicare Advantage Require
Original Medicare requires prior authorization for a short list of services. Medicare Advantage requires it for almost everything. Most of the confusion in a practice comes from treating those two as one payer.
Medicaid Prior Authorization: How It Works and What Changed in 2026
Medicaid prior authorization is not one process. It is a separate program in every state, each with its own rules, plus managed care plans layered on top. Here is how it works, what federal rules now require, and where practices lose money.
Revenue Cycle Management Services: The 7 Stages, What Breaks at Each One, and How to Fix It
Revenue cycle management has 7 stages, and a weak one costs money. This guide walks through every stage of the revenue cycle, shows what goes wrong at each one, and explains how to fix it with or without an outside RCM service.
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