How to Reduce Internal Medicine Denials & Boost Revenue
Are you losing thousands in revenue every month due to claim denials? For many internal medicine practices, nearly 25% to 30% of claims are denied on the first submission, leaving hard-earned money on the table. This isn’t just an administrative hurdle; it’s a leak in your practice’s financial heart that can lead to stalled growth […]
What is the leading reason that claims are denied?
In 2026, healthcare providers are seeing an average in-network claim denial rate of approximately 19%. While payers have increased their use of AI-driven audits, research shows that the vast majority of these denials remain preventable. The leading reason for insurance claim denials is missing or inaccurate administrative information, accounting for nearly 77% of all rejections. […]
Why Psychiatry Claims Get Denied: Top Reasons & Fixes
Are your psychiatry claims getting denied again and again? Is your practice losing significant revenue due to rejected therapy claims? For many mental health providers, the frustration of “denial management” is a daily admin burden. Statistics suggest that even a small denial rate can cost a practice thousands of dollars every month. When a claim […]
Texas Mental Health Parity SB 1125: Denial Appeal Steps
Texas Mental Health Parity SB 1125 mandates that insurers medically manage benefits for mental health or substance use disorder benefits the same way they handle all other physical health conditions. Denied claims can be appealed by patients and providers. Texas psychiatry practices need to be aware of how to appeal these denials to ensure patient access and remain […]
FQHC Psychiatry in Austin: HRSA Grants + G0469 Guide
FQHC Psychiatry Billing in Austin: The use of Section 330 grants and know billing code G0469 is critical for psychiatry practices that are partnering with or considering becoming a Health Resources and Services Administration (HRSA) funded Federally Qualified Health Center in Austin. HRSA grants support for the expansion of behavioral health services and G0469 New patient […]
Telepsychiatry Texas HB 19 Compliance Checklist
Texas HB 19 Telepsychiatry Compliance: Online mental health care is growing fast in Texas. Psychiatrists can now meet patients virtually, making care easier for everyone. But these digital sessions must follow state laws. House Bill 19 (HB 19) outlines the standards that keep remote care safe, private, and legal. This checklist will help clinics meet […]
Child Psychiatry CHIP Billing: 90847 & Foster-Care Codes
Child Psychiatry CHIP Billing in Texas can be difficult. This is especially true for CHIP (Children’s Health Insurance Program) and foster-care cases. Accurate billing is important. It helps practices get paid and follow state and federal rules. This guide is for Texas psychiatry practices and billing teams. It explains billing best practices and gives a […]
Texas Medicaid 2026: New BHW Rules & 7-Day Prior Auth Hacks
If you’re a Texas behavioral health provider and have been worried about what changes are in store for Texas Medicaid behavioral health 2026, the answer is now the subject of this post that on January 1, 2026, Texas must follow a new federal rule that restricts prior authorization (PA) decisions to being made within 7 […]
Spravato + TMS Billing in Texas: REMS Compliance Blueprint
Spravato TMS billing Texas: It’s an apparent paradox How can you bill for Spravato (esketamine) and TMS (Transcranial Magnetic Stimulation) at once? It makes you want to pull your hair out — especially with Texas’ very strict rules. But with a perfect regimen, your clinic can remain REMS compliant and prevent billing errors as you continue to […]
Telehealth Coding Mastery: Avoid Denials with These Proven Tips
Telehealth Coding 2026 can seem like a bit of a wild jungle: different regulations exist between Medicare, commercial insurance payers, and Medicaid. To reduce claim denials, providers need to take care when traveling this path, following payer-specific guidelines and maintaining meticulous documentation as close to coding Adhere to Payer-Specific Coding Guidelines Adhere to Payer-Specific Coding […]
