NatRevMD

Send us Fan Mail Resources  Cybersecurity Incident Response Checklist: https://eligibility.natrevmd.com/natrevmd-cybersecurity-checklist  natrevmd.com  Trusted Resources: https://natrevmd.com/trusted-resources/  A healthcare record sells for 10 to 40 times more than a credit card number on criminal markets, and it cannot be cancelled the way a card can. Independent practices hold that data with th...

Send us Fan Mail Resources  RECOVER Diagnostic: https://eligibility.natrevmd.com/recover-quiz-lp  natrevmd.com  Payment Posting Audit Checklist: https://eligibility.natrevmd.com/payment-posting-checklist  Show notes   A provider sees a patient for a scheduled procedure. A separate problem comes up mid-visit, gets evaluated, and the practice bills both services with Modifier 25 attached. The claim...

Send us Fan Mail  Dr. Emily Ward knew in March 2020 that she was done. She left her gastroenterology partnership in 2023. The reason for the gap was not fear. The practice worked, the money was good, and staying was the rational choice every morning until it was not. She joins Heather to walk through what she built after that, and the part nobody puts in the announcement post: how you actually get...

Send us Fan Mail Part two of two. If you send a specimen to an outside lab and they bill you eighteen dollars for it, eighteen dollars is the most you can bill Medicare. Not your contracted rate. That is the anti-markup rule, and it is one of two things that quietly rewrite the math on in-office lab.  What to pull first. Start from your last 90 days of reference lab orders, grouped by test name an...

Send us Fan Mail In-office lab is one of the most common ancillary additions practices consider, and one of the easiest to get expensively wrong. Part one of two: the framework that decides everything before you spend a dollar.  What CLIA is. The Clinical Laboratory Improvement Amendments, passed in 1988 and administered by CMS, govern all lab testing on human specimens. Every test your practice r...

Send us Fan Mail Before you build a business case for anything, a new hire, a second location, a new service line, three numbers have to be right. Payer mix. Net collection rate. AR days. Most owners have all three. Almost nobody has calculated them correctly in the last two years. This episode is how to fix that, in about twenty minutes, using your own system.    [Payer mix]   The payer mix on yo...

Send us Fan Mail A practice hired a provider in January. The hire was right and she was generating revenue from day one. By March the practice was sixty thousand dollars short and could not make payroll, because nobody had modeled what cash looks like in month two when you are carrying a full salary and the claims are still in the pipeline. This episode builds the model that would have caught it,...

Send us Fan Mail A full schedule is not the same thing as a healthy practice. Our guest this week walked into an independent family practice in Colorado to do finance work, was offered the practice manager role a few weeks later, and quickly found the gap: patients were coming in, the schedule was booked three to five months out, and the money still was not moving. What follows is the sequence she...

Send us Fan Mail She never missed a Monday. Twelve months of weekly billing meetings, every number reviewed, every question answered. And by the end of that year her net collection rate had dropped four points, her ninety-plus AR was up forty percent, and her denial rate had climbed from six percent to eleven. The numbers were there every week. The report was accurate. Nothing changed, because the...

Send us Fan Mail The most expensive billing relationship is not the one that is clearly failing. It is the one that is quietly not delivering. On a practice doing $400,000 a month, three points of net collection rate is $12,000 a month. Nobody escalates $12,000. It does not trigger a phone call. It just leaves, month after month, until somebody adds up a year of it and finds $144,000 that nobody e...

Send us Fan Mail A practice doing seven figures a month switches billing companies, and eighteen months later the denial rate is higher than the day they signed. Nobody lied. Both sides just walked in with a different picture of what good looked like. In this episode we run Alex Hormozi's value equation across a billing partnership, one variable at a time, and name exactly what each side owes...

Send us Fan Mail 👉 Free 30-Day Revenue Recovery Plan: https://eligibility.natrevmd.com/nrc/-30day-revenue-recovery-plan The plan we would build with you if you walked into our office today. Take it home and run it yourself.  ────────────────  Your performance reviews are probably making your billing team worse. Not because you're giving bad feedback. Because the format itself is designed to...

Send us Fan Mail 👉 Free RECOVER Diagnostic: eligibility.natrevmd.com/recover-diagnostic  The exact framework we use when we walk into a new practice. Takes five minutes. Results are immediate.  ────────────────  Only 12 percent of employees strongly agree that their organization does a great job of onboarding. Which means 88 percent of practices — including most independent ones — are spending re...

Send us Fan Mail There is a revenue cliff hiding inside the billing transition most independent practices are planning right now. Not from the change itself. From the order of it. In this episode we walk through why the money in your bank account during month one of a new billing arrangement is almost entirely old AR, why simultaneous service and software change is the fastest way to lose that mon...

Send us Fan Mail 👉 Free RECOVER Diagnostic: eligibility.natrevmd.com/recover-diagnostic  The exact framework we use when we walk into a new practice. Takes five minutes. Results are immediate.  Missed Part 1? EP196: https://podcasts.apple.com/us/podcast/196-%24112-000-buried-by-a-billing-manager-who-was/id1624182351?i=1000777197553 ────────────────  A billing manager with seven years of experienc...

Send us Fan Mail 👉 Free RECOVER Diagnostic: eligibility.natrevmd.com/recover-diagnostic  The exact diagnostic we use when we walk into a new practice. Takes five minutes. Results are immediate.  A billing manager at a family medicine group found an $8,000-per-month denial pattern in her first month. She never said anything. It ran for fourteen months before a billing audit caught it. $112,000 in...

Send us Fan Mail FREE — SEE WHERE YOUR PRACTICE IS BLEEDING REVENUE IN 3 MINUTES Take the RECOVER Diagnostic Quiz: https://eligibility.natrevmd.com/recover-quiz-lp  More free resources: https://natrevmd.com/trusted-resources/  Payment Posting Audit Checklist: https://eligibility.natrevmd.com/payment-posting-checklist WE ARE RE-AIRING THIS EPISODE BECAUSE IT MATTERS RIGHT NOW.  On July 1, 2026, the...

Send us Fan Mail A household runs on clarity, not effort. So does a practice. Most performance problems in independent practices are clarity problems: somebody thought somebody else was handling it. This episode builds the RACI model (Responsible, Accountable, Consulted, Informed) into your billing workflow and your hiring.  What RACI actually means.   Four roles, each assigned to a person for a t...

Send us Fan Mail Q1 2027 cash flow crisis. That is what is waiting for every OB practice that does not have a plan in motion by October. Not because the codes are hard. Because the time ran out to prepare for them. Knowing what is changing and being ready for it are two completely different things. In the OB Global Coding Series finale, Dr. Heather Signorelli walks through the exact ninety-day mon...

Send us Fan Mail Deliver at 11 PM Tuesday and round at 1 AM Wednesday: paid. Deliver at 8 AM Tuesday and round at 4 PM Tuesday: included in the delivery code, and billing it separately is a compliance violation. Same clinical work, two different outcomes. The only variable is the calendar. Starting January 1, 2027 postpartum care moves to E/M billing with hospital rounds, discharge management, and...

Send us Fan Mail Under the global model, labor management was absorbed into the delivery code. Two hours or twenty-two, same payment. Starting January 1, 2027, the AMA introduces 59080 through 59083, the first dedicated labor management codes in CPT history. The work was always there. Now it gets paid. Dr. Heather Signorelli and Amy Hicks, CPC, COBGC, our AVP of Operations, walk through the codes,...

Send us Fan Mail Starting January 1, 2027 every antepartum visit becomes its own billable E/M charge. The global OB code goes away. The seventeen deleted codes include 59400, 59510, 59425, and 59426. And the way most prenatal notes are written today supports a 99212 at best, even when the visit was genuinely a 99214. Dr. Heather Signorelli and Maria Reynoso, Director of RCM at NatRevMD, walk throu...

Send us Fan Mail Show notes   A physician built a solid, growing independent practice over six years, then got bored with the pace and chased three new ideas at once. None launched. The original practice still lost an estimated $180,000 in revenue degradation over twelve months, not from a bad decision, but from the boring work quietly going undone. This episode is the framework for staying in the...

Send us Fan Mail Show notes   On January 1, 2027, every global OB code your practice has billed for the last thirty years is being deleted. Seventeen CPT codes. Gone. Replaced with a completely new structure for how every dollar of maternity revenue is earned, attributed, and collected. And the real deadline for your practice is not January 1, 2027. The real deadline is right now.  What is actuall...

Send us Fan Mail Show Notes  Your fee schedule is a revenue ceiling. And for most independent practices doing over $3 million a year, that ceiling is set too low in ways that never generate a denial and never appear on a standard report.  EP186 covers the five gaps that are quietly capping your revenue, the exact fix for each one, and three actions to run this week.  Gap 1 — Billing Below Your Own...