Blog posts by John Gwin

We stay up to date on the ever-changing insurance market's impacts on your specialty for you...because it's basically a full time job in and of itself.

May 9, 2026
by John Gwin

Clean Claim Rate, AR Aging, and DRO: The 4 Billing KPIs Every Practice Should Track

What Is a Good Clean Claim Rate? Ninety-five percent. That’s the floor. The reciprocal is a 5% denial rate — which sounds manageable until you see how many follow-up hours that 5% generates downstream. Most practices below 95% aren’t losing to payer behavior. They’re losing to their own intake process. Three variables move this number […]

February 24, 2026
by John Gwin

Plastic Surgery Billing Red Flags That Impact AR, Denials, and Cash Flow

In plastic surgery billing, accounts receivable, often referred to as AR, rarely deteriorates overnight. More often, AR slowly drifts. Denials increase, aging stretches out, cash flow tightens, and leadership assumes it is a payer issue. AR is a slow burn… once you notice a fire is it often too late or at least you’ve lost […]

November 17, 2025
by John Gwin

Medicare Prior Authorization for Ambulatory Surgical Centers: What Providers Need to Know (2025 Update)

Medicare Prior Authorization for Ambulatory Surgical Centers: What You Need to Know (2025 Update) Oh, 2025. Just when you thought you’d finally made peace with paperwork, CMS pulls a rabbit out of its regulation hat—another prior authorization rule, this time for ambulatory surgical centers (ASCs) in ten of America’s biggest, boldest states. Spoiler alert: If […]

November 7, 2025
by John Gwin

AI and ML in Billing: How They’re Changing the Game

The Future of Medical Billing Technology Is Already Here Remember when “AI” sounded like something from a sci-fi movie? Yeah, same. Now it’s sitting in your billing software, quietly doing more in five seconds than a human could in five hours — without the caffeine dependency. Artificial Intelligence (AI) and Machine Learning (ML) are no […]

November 6, 2025
by John Gwin

Senjie Tayactac – Authorization Team Lead

Senjie Tayactac – Authorization Team Lead Ever met someone who can juggle patient authorizations, wrangle clinical notes, troubleshoot queues, and still be a devoted mum of three? Meet Senjie Tayactac — our powerhouse Authorization Team Lead who’s redefining the word multitasker. Dinner Date with a Side of Heart If Senjie could share a meal with […]

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