Healthcare Management Solutions, LLC

08/19/2026

Every practice has a point where the revenue cycle seems to lose momentum. Where does yours slow down most often?

A. Insurance verification
B. Coding or claim submission
C. Denial follow-up
D. Patient balances

There is no wrong answer but the answer can reveal where better training, clearer ownership, or a stronger workflow may make the biggest difference.

Comment A, B, C, or D—and tell us what makes that step difficult.

08/17/2026

A clean claim does not begin when someone clicks Submit. It begins with accurate information collected before the visit.

Five items worth checking before the claim leaves your system:
1. Patient name and date of birth match the insurance record
2. Member ID and payer are current
3. Provider enrollment, NPI, and taxonomy are correct
4. Authorization and referral requirements are documented
5. CPT, diagnosis, modifiers, and place of service support the service billed

A few minutes of prevention can save days, or weeks of rework later.

Save this checklist and share it with the person who handles intake or claim review.

08/14/2026

Medical Billing Translation Dictionary:

Payer: “Your claim was denied.”
Practice: “Why?”
Payer: “Please review the explanation.”
Explanation: “Claim denied.”

If you have ever read an EOB twice and somehow understood less the second time, you are not alone. The key is to look past the generic description and confirm the adjustment and remark codes, payer policy, and original claim details before deciding what to do next.

What is the most unhelpful denial message you have received?

08/13/2026

Please join us in welcoming the newest member of the Healthcare Management Solutions team!

We're excited to announce that Tamara Gilliss has joined Healthcare Management Solutions as a full-time Medical Billing Specialist.

Tamara brings a patient-first mindset to everything she does. She believes every patient deserves accurate billing, fair insurance processing, and compassionate service. Her goal is simple: to make sure insurance companies pay according to the patient's benefits so providers can focus on delivering exceptional care and patients can focus on their health, not their health plan.

Outside of work, Tamara enjoys spending time with her family, playing pickleball, enjoying the outdoors, and exploring the arts. As the proud mother of four accomplished adult children, she understands the importance of caring for others with the same compassion and respect she would want for her own family.

At HMS, we're committed to providing knowledgeable, responsive, and personalized revenue cycle management services, and we're thrilled to have Tamara helping us continue that mission.

Please join us in giving Tamara a warm welcome!

💙 Welcome to the HMS family, Tamara!

06/15/2026

Let's talk healthcare business.

What's one thing you wish they taught in school that would have helped you run your practice?

I'll go first:

Revenue cycle management.

Many providers graduate knowing how to care for patients but receive very little education about insurance reimbursement, denials, or cash flow management.

Drop your answer below 👇

06/12/2026

The money you're looking for might already be sitting in your aging accounts receivable.

We frequently review AR reports and discover:

✔ Claims never followed up on
✔ Incorrect denials
✔ Missing secondary claims
✔ Unresolved payer requests

Many practices assume old claims are uncollectible.

Often, they simply haven't been worked.

Don't leave earned revenue on the table.

06/10/2026

🎓 Continuing education isn't just for providers.

Today I'm attending a webinar on "Avoiding the Medicare (and/or Medicaid) Death Penalty" presented by Fredrikson.

While the title certainly grabs your attention, the topic highlights something every healthcare practice should be thinking about:

Is your billing team staying current on the regulatory, compliance, and payer changes that could impact your practice?

Healthcare reimbursement is constantly evolving. Medicare updates, Medicaid requirements, documentation expectations, audits, enrollment changes, and compliance risks can all affect a practice's revenue and operations.

The reality is that medical billing isn't just about submitting claims anymore. It's about understanding the ever-changing healthcare landscape and helping providers navigate it successfully.

At HMS, ongoing education is a priority because what we learn today may help our clients avoid costly issues tomorrow.

Whether your billing is handled internally or outsourced, it's worth asking:

❓ How does your billing team stay informed?
❓ What continuing education do they participate in?
❓ How are regulatory and payer updates communicated to your practice?

Staying current isn't optional in healthcare it's part of protecting your revenue, your compliance, and your peace of mind.

06/10/2026

📢 Credentialing Update: CAQH Has a New Name

If you've logged into CAQH recently, you may have noticed something different.

CAQH has officially rebranded and is now called DataSpring.

Before you panic about learning a new system, here's the good news:

✅ Same platform
✅ Same login credentials
✅ Same profile information
✅ Same attestation process

The name has changed, but the function has not.

Your DataSpring profile remains one of the primary sources insurance companies use for:

• Credentialing and enrollment
• Provider directory information
• Claims processing verification
• Network participation updates

In other words, it's still one of the most important pieces of your revenue cycle and payer compliance process.

💡 Our recommendation:

Take 10 minutes this week to log in and review your profile.

Verify:
✔ Practice address
✔ NPI information
✔ Licensure details
✔ Insurance panel participation
✔ Contact information

Then re-attest your profile if it's due.

We've seen countless claim delays, enrollment issues, and provider directory errors that could have been prevented with a simple profile review.

No urgent action required. No major system changes.

Just a good reminder that keeping your provider data current can save a lot of headaches down the road.

06/09/2026

06/08/2026

One of my favorite parts of what we do at HMS isn't billing.

It's teaching.

We regularly work with providers and office staff who simply want to better understand insurance, claims, denials, and revenue cycle management.

When teams understand the "why" behind the process, everything improves:

✔ Fewer mistakes
✔ Better documentation
✔ Faster payments
✔ Less frustration

Sometimes the best solution isn't outsourcing.

Sometimes it's education.