BLOGS

Healthcare practices are facing growing pressure as medical billing and revenue cycle management become harder to sustain internally. Rising claim denials, tighter payer requirements, authorization delays, and staffing constraints are disrupting cash flow across specialties. This article examines why getting paid has become more difficult heading into 2026 and how practice leaders can gain clarity on what revenue is still recoverable before it expires.

Unless a new agreement is made, UNC Health will be out-of-network for Cigna commercial plans starting December 1. I, like over 60,000 other North Carolinians, have just over five weeks to find a new primary care provider.

With only days left before October 1, physicians must understand what’s really at stake. A mid-sized practice that bills for 20 high-level visits per week could lose $4,000 to $5,000 per month if claims are downcoded. Over 12 months, this amounts to nearly $50K in lost reimbursements. On October 1, 2025, Cigna Healthcare will enforce its new Evaluation and Management (E/M) Coding Accuracy (R49) Policy. This change is significant for many physicians; it represents a seismic s