VOSKPO News & Insights
Practical guidance on medical billing, denial management, healthcare analytics, compliance, and the technology that runs a healthier revenue cycle.
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The industry denial rate hit 9% and days in A/R hit 42. Both numbers are averages, and the same report that published them shows four specialties failing for four completely different reasons — each one a modifier, a filing window or a fee schedule, not a culture problem.
Clinics and physician practices are on pace for fourteen Chapter 11 filings this year, and an investment banker has put a number on the minimum size needed to stay independent: forty to fifty providers. That figure is not a law of practice economics. It is a cost estimate, and automation changes what it costs.
A Blue Cross and Blue Shield of Illinois policy live since 1 July pays E/M claims at a lower level than billed. Most Work RVU compensation agreements have no clause for that gap — so the practice management software has been deciding it, monthly.
HFMA's 2026 Revenue Cycle Benchmark Report, published 28 July, names denials and appeals the industry's top concern. The finding underneath it — expanding audit activity, and the takebacks that follow — is the one almost no independent practice is planning for.
The AMA is building a new class of CPT codes to reimburse clinical work performed entirely by AI, with the comment window closing 10 August 2026. Here's why the Charge Capture and Denial Management decisions made in the next six weeks will decide who absorbs the next round of payer scrutiny.
The GAO has put CMS's WISeR prior-authorization model on the path to possible congressional repeal. Whether it survives or not, the documentation lesson it has already taught will change how independent practices protect their cash flow.
Insights
Prior authorization, NCCI bundling edits and payer AI are converging on claims at once in 2026. Here is the three-force breakdown, and the prevention plan that stops all three before they become denials.
CMS-0057-F was supposed to simplify prior authorization. Instead it made data-field precision mandatory, and independent practices are absorbing a 31% denial spike. Here is the PA-first workflow that stops it.
Payers now use AI to scan clinical notes before a claim ever reaches a human. Reactive denial management cannot keep up, so here is what fighting AI with AI actually looks like.
56% of denials trace back to patient eligibility, not coding. Here is why continuous verification, not better coding, is the fastest lever on your clean claim rate in 2026.
Median days in A/R have stretched past 52 days industry-wide. Here is why prevention, not faster follow-up, is the only way to get practices back under 30.
66% of practices now outsource all or part of their revenue cycle. Here is how to avoid becoming a ticket number, and the five questions that separate a partner from a vendor.
288 new CPT codes took effect January 1, 2026. Here is what changed in the CMS fee schedule, why most practices fall behind, and how to capture the new revenue without inviting an audit.
Earlier articles
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