A 95-day NICU journey, a tiny survivor, and the uncomfortable truth about the administrative systems that determine whether physicians can keep doing what they do best: care for patients.
“Patients should not have to fight the healthcare system
to get the care they need and deserve.” — Willie
Underwood III, MD, MSc, MPH, President, American Medical Association
A 2-Pound, 10-Ounce Baby, a 95-Day NICU Stay, and the
Healthcare Problem We Don't Like to Discuss
Two years ago, Reyanne Maya was 30 weeks pregnant and
visiting Las Vegas.
She did not know that her trip was about to become a 95-day
journey through one of the most intense parts of American medicine.
Reyanne needed an emergency C-section.
Her daughter, Tennessee “Tenny” Maya, was born
weighing just 2 pounds, 10 ounces.
Ten days later, Tenny developed a life-threatening
intestinal condition.
Surgeons removed approximately 65 centimeters of damaged
intestine.
Then came the NICU.
Ninety-five days.
Today, Tenny is a thriving two-year-old.
Her mother has turned the experience into a children's book
inspired by her daughter's strength. Sunrise Children’s Hospital in Las Vegas
shared Tenny's story during NICU Awareness Month while recognizing the families
and care teams behind more than 1,000 NICU journeys there each year.
There is something deeply human about that story.
A tiny baby.
A frightened mother.
A team of clinicians.
A difficult surgery.
A long hospitalization.
And, eventually, a child who gets to go home.
But here is the uncomfortable question:
What happens after the medicine works?
Because the hospital stay may end.
The surgery may be successful.
The child may recover.
The family may finally breathe.
But the healthcare machine does not stop.
The claim still has to be coded.
The documentation has to support it.
The payer has to process it.
The denial has to be investigated.
The underpayment has to be found.
The appeal has to be written.
The A/R has to be worked.
Someone has to reconcile the money.
And someone, somewhere, has to figure out why the practice
delivered excellent care but did not get paid correctly for it.
That someone is often the physician.
Or the office manager.
Or the practice administrator.
Or the exhausted employee who has three browser windows
open, two spreadsheets running and a payer portal asking them to reset their
password again.
Welcome to modern medicine.
We have built extraordinary technology to save patients
and remarkably primitive workflows to get physicians paid.
That contradiction deserves more attention.
The Contrarian Idea: Billing Is Not “Back Office”
Physicians are trained to think in clinical categories.
Patient care is important.
Administration is necessary.
Billing is somewhere in the administration bucket.
I think that framework is wrong.
Billing is part of the clinical infrastructure of a
medical practice.
Not because physicians should become accountants.
Not because revenue is more important than patients.
And certainly not because every physician secretly dreamed
of spending medical school learning payer rules.
The reason is simpler.
A financially dysfunctional practice eventually becomes a
clinically dysfunctional practice.
If claims are routinely denied, cash flow suffers.
If cash flow suffers, hiring becomes harder.
If hiring becomes harder, staff become overloaded.
If staff become overloaded, administrative errors increase.
If errors increase, physicians get pulled into more cleanup.
If physicians get pulled into more cleanup, clinical time
becomes more expensive.
And if the practice cannot sustain itself, access eventually
suffers.
That is not theoretical.
It is a systems problem.
The AMA has continued to highlight the connection between
physician payment, administrative burden and patient access. On September 4,
2026, AMA President Willie Underwood III, MD, wrote that delays in Medicare
reform and prior authorization can harm patients and make it harder for
physicians to provide timely care.
The uncomfortable truth is that bad administration can
become a patient-care problem without ever appearing in the patient's chart.
That is the part we need to talk about.
The Healthcare Industry Has a Strange Definition of
Efficiency
Think about how much money healthcare spends trying to
improve efficiency.
Artificial intelligence.
Robotics.
Remote monitoring.
Predictive analytics.
Precision medicine.
Interoperability initiatives.
Population health.
Clinical decision support.
We will spend millions discussing how to save 30 seconds
during a clinical workflow.
Then we may allow a claim worth hundreds or thousands of
dollars to sit in A/R because nobody has clearly assigned ownership.
That is not efficiency.
That is theater.
And it is surprisingly common.
A physician may spend years developing clinical expertise,
build a practice, hire staff, purchase equipment, maintain compliance, pay
malpractice insurance, lease space and see patients all day.
Then the financial engine of the practice can depend on a
collection of disconnected systems:
EHR.
Clearinghouse.
Payer portal.
Billing company.
Fax.
Email.
Spreadsheet.
Phone call.
Sticky note.
And, occasionally, the ancient healthcare technology known
as:
“I think Susan handled that.”
Susan has no idea.
Susan left six months ago.
Nobody knows the password.
The claim is now 87 days old.
This is how revenue leakage happens.
Not necessarily through dramatic fraud.
Through friction.
Friction Is Expensive
The AMA's STEPS Forward program recently made an important
point about workflow design: small sources of friction can consume valuable
cognitive bandwidth, and fixing low-complexity, high-annoyance problems can
create momentum for deeper change.
That observation applies beautifully to medical billing.
A physician does not need one giant billing disaster to lose
money.
The leakage can happen in hundreds of small places.
A missing modifier.
An unsupported level of service.
A coding mismatch.
A claim submitted late.
An eligibility problem.
A documentation gap.
A denial nobody appealed.
An underpayment nobody noticed.
A secondary claim that never went out.
A payer rule that changed.
A staff member who does not know the new rule.
One error may be trivial.
Multiply it by 20 visits a day.
Then 100 visits a week.
Then 5,000 encounters a year.
Suddenly the “small” problem has a six-figure shadow.
The American Academy of Family Physicians explicitly notes
that accurate coding supports payment, reduces audit risk and captures the
complexity of care. Its current billing and coding resources also cite an
estimate of $30,000 in average annual lost revenue from undercoding a few
times a day.
The lesson is not “code more aggressively.”
The lesson is:
Document accurately. Code accurately. Bill accurately.
Follow the money.
Those are very different things.
The Myth: “We Have a Billing Company, So Billing Is
Solved”
This is probably the most dangerous assumption in
independent practice.
And I say that carefully.
Outsourcing billing can absolutely make sense.
Third-party billing vendors can provide expertise, staffing
and infrastructure that a small practice may not want to build internally. AMA
coverage has also recognized situations in which third-party billing can
improve private-practice efficiency.
The problem is not outsourcing.
The problem is outsourcing without visibility.
You can outsource the work.
You cannot outsource accountability.
That distinction matters.
If a vendor tells you:
“Your clean-claim rate is 96%.”
Great.
What about:
- Net
collection rate?
- Denial
rate?
- Days
in A/R?
- A/R
over 90 days?
- First-pass
acceptance?
- Underpayment
rate?
- Appeal
success rate?
- Coding
variance?
- Missing
charges?
- Payer-specific
performance?
- Dollars
at risk?
- Dollars
recovered?
If the answer is:
“I'm not sure.”
Then you don't have a billing strategy.
You have a billing relationship.
Those are not the same thing.
The Physician Should Not Become a Biller
Let me be equally contrarian on the other side.
The answer to broken billing is not to turn
physicians into billing specialists.
Physicians already have enough jobs.
Diagnostician.
Proceduralist.
Counselor.
Documentation specialist.
Team leader.
Recruiter.
Compliance officer.
Employer.
Negotiator.
Technology evaluator.
And, increasingly, unpaid customer-service representative
for the healthcare system.
We should not add:
Part-time certified revenue-cycle analyst.
The better model is physician oversight without physician
micromanagement.
A practice owner should understand the economics of the
practice.
But the physician should not be spending Tuesday afternoon
calling a payer about claim number 847291.
That is not physician-level work.
It is a workflow failure.
Three Experts, Three Lessons
1. Willie Underwood III, MD: Payment Problems Become
Patient Problems
AMA President Willie Underwood III, MD, MSc, MPH has
been outspoken about the relationship between administrative and payment
barriers and patient access.
His September 4, 2026 commentary emphasized the harm that
delays in Medicare reform and prior authorization can create for patients and
physicians.
The lesson for practice owners is bigger than Medicare
policy.
Revenue-cycle friction eventually touches care delivery.
If your practice cannot predict when money will arrive, you
cannot plan confidently.
Hiring becomes harder.
Technology investments get delayed.
Staffing becomes reactive.
And physicians end up carrying operational uncertainty that
should have been managed by the system.
2. Liz Harry: Stop Teaching People to Cope With Broken
Workflows
The AMA STEPS Forward discussion this week featured Liz
Harry, chief well-being officer at Michigan Medicine, emphasizing an idea
that deserves to become standard practice:
Redesign the workflow instead of simply teaching people to
tolerate the workflow.
That distinction is enormous.
Healthcare has a strange habit of treating administrative
dysfunction as an employee wellness issue.
The inbox is overflowing?
Offer mindfulness.
The EHR takes forever?
Offer resilience training.
Billing staff are drowning?
Offer pizza.
Physicians are exhausted?
Offer yoga.
There is nothing wrong with yoga.
But yoga cannot fix a broken revenue cycle.
Wellness cannot compensate indefinitely for bad system
design.
If a process repeatedly creates unnecessary work, fix the
process.
3. Thomas Weida, MD, FAAFP: Small Coding Errors Can
Become Big Money
The AAFP's billing and coding guidance cites Thomas
Weida, MD, FAAFP, in estimating that undercoding a few times each day can
cost a practice approximately $30,000 annually.
That is an important reminder.
Revenue optimization does not always require inventing a new
revenue stream.
Sometimes the revenue is already sitting inside the
practice.
It simply isn't being captured.
You don't necessarily need more patients. You may need
better execution on the patients you already have.
That is a very different growth strategy.
The 2027 Medicare Warning Shot
The timing could not be more relevant.
On September 4, 2026, the AMA published an analysis of the
proposed 2027 Medicare physician fee schedule, highlighting proposals
involving same-day E/M services, maternity care codes, remote monitoring and
other payment issues.
The AMA also reported this week that more than 150 medical
specialty societies are urging CMS not to finalize a proposed 50% payment
reduction for certain separately identifiable office/outpatient E/M services
reported with modifier 25 on the same day as certain procedures.
Whether you agree with every advocacy position is beside the
point.
The larger lesson is obvious:
Payment rules are moving targets.
A workflow that worked last year may not be optimal next
year.
A code that staff understand today may require different
interpretation tomorrow.
A modifier that looks insignificant can become financially
significant at scale.
This is why “we've always done it this way” is not a billing
strategy.
It is nostalgia.
What Physicians Should Actually Measure
If you own a practice, you should know these numbers.
Not your billing company.
Not just your office manager.
You.
Not every morning.
But often enough to see the trend.
1. Days in A/R
How long does it take for billed revenue to become collected
revenue?
A growing number is a warning.
2. A/R over 90 days
Old A/R deserves disproportionate attention.
Money becomes harder to collect as it ages.
3. Denial rate
Don't just ask how many claims are denied.
Ask:
Why?
A denial categorized as “insurance issue” is not an
analysis.
It is a shrug.
4. Clean-claim rate
How many claims make it through the initial submission
without requiring correction?
5. Net collection rate
How much collectible revenue actually becomes cash?
6. Underpayment rate
This is where many practices become uncomfortable.
A claim can be “paid” and still be wrong.
Payment does not automatically mean correct payment.
7. Charge capture
Were all billable services actually captured?
8. Coding variance
Are different clinicians documenting and coding similar
encounters in dramatically different ways?
Variation is not automatically wrong.
But unexplained variation deserves investigation.
9. Appeal recovery
How much money is recovered after denial?
If the number is zero, ask why.
10. Revenue per encounter
This should never become an excuse to over-treat or
over-code.
It should become a way to understand whether the practice is
accurately capturing legitimate work.
The Most Dangerous Billing Number Is Sometimes the One
That Looks Good
Here is a counterintuitive point.
A high collection rate can hide problems.
Imagine a practice has a 97% collection rate.
Sounds fantastic.
But 97% of what?
If the practice routinely undercodes legitimate services,
the denominator itself may be too small.
You could collect 100% of an inaccurately low amount.
Congratulations.
You achieved perfect efficiency at losing money.
This is why revenue-cycle metrics have to be interpreted
together.
A dashboard without context is just a colorful spreadsheet.
The “More Patients” Trap
When revenue is weak, physicians often hear one
recommendation:
See more patients.
It is simple.
It is measurable.
And sometimes it is completely wrong.
If your revenue cycle is leaking 5% to 10% of legitimate
collectible revenue, adding more volume can make the administrative problem
worse.
More patients mean:
More claims.
More documentation.
More coding.
More denials.
More A/R.
More staff workload.
More opportunities for leakage.
You may end up running faster on a treadmill that is moving
backward.
Before increasing volume, ask:
How much of the work we already perform are we
successfully converting into revenue?
That question can be worth more than another half-day of
clinic.
Where AI Actually Belongs in Medical Billing
Let's talk about AI.
There is a lot of hype.
Some of it is deserved.
Much of it is not.
The wrong question is:
“Where can we put AI?”
The right question is:
“Where is the repetitive cognitive work that a machine
can perform reliably while humans retain appropriate oversight?”
Billing has plenty of candidates.
AI can potentially help identify:
- Missing
information
- Documentation
inconsistencies
- Coding
anomalies
- Claim-edit
patterns
- Denial
trends
- Payer-specific
behavior
- Underpayment
patterns
- A/R
prioritization
- Repetitive
administrative tasks
- Workflow
bottlenecks
But AI should not become a magical black box that tells a
physician:
“Trust me.”
Healthcare needs the opposite.
Show me.
Show me the claim.
Show me the documentation.
Show me the rule.
Show me the pattern.
Show me why this was flagged.
Show me what happened after the intervention.
That is how AI becomes useful rather than theatrical.
The Human Still Matters
Technology does not eliminate judgment.
It changes where judgment is applied.
A machine can identify a pattern.
A human must determine whether the pattern makes sense.
A machine can flag a denial.
A human may need to understand the clinical and contractual
context.
A machine can organize A/R.
A human still has to decide what deserves attention.
The best billing system is therefore not:
AI versus humans.
It is:
AI for repetitive work + humans for judgment.
That is the model worth pursuing.
A Practical 30-Day Revenue-Cycle Reset
If I were walking into an independent medical practice
tomorrow, I would not start with a giant technology project.
I would start with the data.
Week 1: Find the leaks
Pull the last 90 days of:
- Claims
- Denials
- Payments
- A/R
- Adjustments
- Write-offs
- Payer
mix
- CPT
distribution
- E/M
distribution
- Days
to payment
Then categorize the problems.
Don't say:
“Billing is bad.”
Say:
“Twenty-seven percent of our denials are
eligibility-related.”
Specificity creates action.
Week 2: Find the expensive problems
Rank issues by dollars, not irritation.
A problem that annoys staff but costs $200 may be less
urgent than a boring problem costing $40,000.
This sounds obvious.
It isn't.
Organizations routinely optimize whatever is loudest.
You should optimize what is most expensive and most
fixable.
Week 3: Fix one workflow
Choose one high-impact problem.
For example:
Eligibility verification.
Missing modifiers.
Incomplete documentation.
Denial follow-up.
Charge capture.
Then redesign the workflow.
Assign ownership.
Define the expected result.
Measure it.
Do not launch seventeen initiatives.
Healthcare already has enough committees.
Week 4: Automate the repeatable
Once the workflow is understood, ask:
What can be automated?
Then:
What should remain human?
That order matters.
Automating a broken workflow does not create efficiency.
It creates a faster broken workflow.
What OnnX Is Trying to Change
This is where my own work comes into the conversation.
I founded OnnX around a simple observation:
Small and medium-sized medical practices should not need a
maze of intermediaries just to understand and manage their own revenue cycle.
The goal is not to make physicians think about billing all
day.
Quite the opposite.
The goal is to make the billing operation more visible, more
intelligent and less dependent on unnecessary manual work.
That means using technology to reduce friction.
It means giving practices better visibility into what is
happening.
It means identifying opportunities and problems earlier.
And it means keeping physicians and practice owners in
control of the economics of their own businesses.
Because there is something fundamentally strange about
owning a medical practice while having limited visibility into how the money
moves through it.
You own the clinical operation.
You employ the people.
You take the regulatory risk.
You carry the overhead.
You serve the patients.
You make the clinical decisions.
You should also understand your revenue cycle.
But Here Is What I Don't Believe
I don't believe every practice needs AI.
I don't believe every billing company is bad.
I don't believe every denial is someone else's fault.
I don't believe every physician is undercoding.
I don't believe more technology automatically means better
healthcare.
And I don't believe revenue optimization should become a
euphemism for aggressive coding.
That last point matters most.
The objective is not to extract every possible dollar.
The objective is to accurately capture the value of
legitimate care.
That means:
No upcoding.
No manufactured complexity.
No inappropriate modifiers.
No gaming.
No documentation designed backward from reimbursement.
No shortcuts that create compliance risk.
The strongest revenue cycle is not the most aggressive one.
It is the most accurate one.
The Legal and Compliance Line
Physicians and practice owners should be careful here.
Revenue optimization can quickly cross into compliance
territory if the objective becomes maximizing reimbursement without regard to
whether the underlying service, documentation and coding support the claim.
Coding must reflect the services actually provided.
Documentation should support the billed service.
Modifiers should be used appropriately.
Medical necessity remains fundamental.
And practices should maintain appropriate compliance
processes.
The AAFP emphasizes accurate documentation, appropriate
coding and correct use of modifiers as part of sound billing practice.
The safest philosophy is simple:
Don't code to get paid. Code what happened, document what
you did, and get paid accurately for it.
The Ethical Question Nobody Should Avoid
There is an ethical dimension to billing that goes beyond
compliance.
Physicians sometimes feel guilty talking about money.
I understand why.
Medicine is a profession built around service.
But avoiding financial conversations does not make financial
incentives disappear.
It merely means somebody else controls them.
There is nothing unethical about building a financially
healthy practice.
In fact, there is an ethical argument for doing so.
A sustainable practice can:
- Keep
clinicians employed.
- Maintain
equipment.
- Invest
in technology.
- Offer
patient access.
- Support
staff.
- Serve
communities.
- Continue
operating when reimbursement changes.
Financial health is not the opposite of patient care.
It can be one of the conditions that makes patient care
sustainable.
The Real Enemy Isn't Billing
This may be the most contrarian point in the entire article.
Billing is not the enemy.
Bad billing isn't even necessarily the enemy.
The deeper enemy is unnecessary complexity.
A physician documents.
A coder interprets.
A billing system transforms.
A clearinghouse processes.
A payer adjudicates.
A vendor reports.
A dashboard summarizes.
A manager interprets the dashboard.
And eventually the physician asks:
“Wait. Why did we get paid this amount?”
That is too many layers between the work and the
understanding of the work.
Healthcare has accumulated intermediaries because each one
solved a problem at a particular moment.
But solving yesterday's problem by adding another layer can
create tomorrow's problem.
The future should be about removing friction, not adding
software for the sake of software.
What the Tenny Maya Story Has to Do With All of This
At first glance, almost nothing.
Tenny's story is about a premature birth, an emergency
C-section, a life-threatening intestinal condition, surgery and a 95-day NICU
stay.
It is about medicine at its most human.
Billing seems like a completely different universe.
But look closer.
Behind every successful medical outcome is an enormous
operating system.
People.
Protocols.
Staff.
Technology.
Documentation.
Supplies.
Facilities.
Contracts.
Payments.
The public sees the miracle.
Healthcare leaders also have to manage the machinery that
makes the miracle possible.
That is not glamorous.
There is no Hollywood movie about a clean claim.
Nobody writes a children's book about a perfectly reconciled
A/R report.
And nobody rings a bell when a denial gets appealed
successfully.
Maybe they should.
Because healthcare depends on thousands of invisible
victories.
The Future Belongs to Practices That Understand Their
Data
The independent practice of the future will not necessarily
be the largest practice.
It may be the smartest.
It may know:
Which payers pay slowly.
Which codes generate recurring denials.
Which clinicians have documentation variation.
Which claims are aging.
Which workflows create staff frustration.
Which dollars are being left behind.
Which processes can be automated.
And which processes should never be automated.
This is not about turning doctors into business executives.
It is about giving physician-owners enough information to
make good decisions.
The same principle applies clinically.
You would not diagnose a patient without information.
So why run a practice without financial information?
Seven Questions Every Physician-Owner Should Ask This
Month
- What
percentage of our A/R is older than 90 days?
- What
are our three most common denial reasons?
- How
much money did we fail to collect last quarter?
- How
much of our revenue cycle still depends on manual work?
- Can
I see payer performance by dollar, not just by claim count?
- Can
I explain our billing process from patient encounter to payment in five
minutes?
- If
our billing team disappeared tomorrow, would we understand what was
happening?
That last question is uncomfortable.
It is also revealing.
If the answer is no, you have an operational dependency.
Not necessarily a vendor problem.
A visibility problem.
Three Billing Myths Physicians Should Retire
Myth #1: “Paid means correct.”
No.
A claim can be paid incorrectly.
Payment is an event.
Accuracy is a process.
Myth #2: “Our billing company handles it.”
Maybe.
But if you cannot see the metrics, trends and problems, you
cannot manage the outcome.
Outsourcing execution is reasonable.
Outsourcing understanding is dangerous.
Myth #3: “The only way to increase revenue is to see more
patients.”
Sometimes the fastest revenue improvement is not another
appointment.
It is capturing and collecting the revenue associated
with care you are already providing.
More volume is not always growth.
Sometimes it is just more work.
Five Pitfalls to Avoid
1. Chasing every dollar equally
Prioritize by financial impact.
2. Measuring activity instead of outcomes
“Claims submitted” is an activity.
“Cash collected” is an outcome.
3. Automating before understanding
Map the process first.
4. Treating staff frustration as a personality problem
Repeated frustration often signals workflow friction.
5. Turning compliance into an afterthought
The smartest revenue strategy is the one that survives
scrutiny.
The Physician-Owner's New Role
The physician-owner does not need to become a billing
expert.
But the physician-owner should become a revenue-cycle
literate leader.
That means understanding the vocabulary.
Understanding the dashboard.
Asking better questions.
Knowing where the risk lives.
Knowing where the opportunity lives.
And refusing to accept:
“That's just how billing works.”
Maybe it is.
But maybe it shouldn't be.
That sentence has protected a lot of bad processes for a
very long time.
A Better Mental Model
Think about your practice as three connected systems.
Clinical system
You deliver care.
Administrative system
Your team documents, schedules, authorizes and coordinates.
Financial system
The organization captures, submits, adjudicates and collects
payment.
Most practices obsess over the first.
Many struggle with the second.
Too few truly understand the third.
But they are connected.
Clinical quality without operational sustainability is
fragile.
Operational efficiency without clinical integrity is
dangerous.
Financial optimization without ethics is unacceptable.
The goal is all three.
What Happens Next?
Healthcare is heading toward more automation.
More AI.
More payer complexity.
More data.
More payment-model experimentation.
More scrutiny.
And more pressure on independent physicians.
The answer cannot simply be:
“Hire another person.”
At some point, we have to redesign the system.
The technology exists.
The data exists.
The expertise exists.
The question is whether we are willing to use them
intelligently.
Final Thoughts: Stop Treating Revenue as Someone Else's
Problem
Tennessee “Tenny” Maya's story is ultimately about something
much bigger than a hospital stay.
It is about what happens when people, expertise, technology
and persistence come together to protect a vulnerable human being.
That is what healthcare is supposed to do.
But the system surrounding that care also matters.
A practice that cannot manage its revenue eventually loses
options.
And options matter.
They determine whether you can hire another nurse.
Whether you can replace an aging piece of equipment.
Whether you can invest in better technology.
Whether you can keep your doors open.
Whether you can continue serving the community.
So here are three things I would challenge every
physician-owner to do:
Know your numbers.
Fix the friction.
Protect the mission.
Do not confuse revenue-cycle discipline with greed.
Do not confuse administrative complexity with
sophistication.
And do not accept broken workflows simply because healthcare
has lived with them for decades.
Tenny's story reminds us what is worth protecting.
The patient is the mission.
The practice is the vehicle.
And the revenue cycle is the fuel.
You do not worship the fuel.
But you cannot drive without it.
Continue the Conversation
I would genuinely like to hear from physicians and practice
owners:
What is the single most frustrating part of your medical
billing process today?
Is it denials?
Prior authorization?
Slow payments?
A/R?
Coding?
Lack of visibility?
Your billing vendor?
Your EHR?
Or simply the feeling that you are spending too much time
managing a system that was supposed to support your practice?
Tell me in the comments.
Your experience may help another physician recognize a
problem they have been quietly tolerating.
If this article gave you one useful idea, share it with a
physician-owner or practice administrator who needs to see it.
And if you disagree with me, even better.
Tell me where I'm wrong.
The healthcare system gets better when the people living
inside it are willing to challenge its assumptions.
A Practical Free Resource
For physician-owners who want to go deeper, I recommend
starting with a simple Revenue-Cycle Health Check:
Track:
- Days
in A/R
- A/R
over 90 days
- Denial
rate
- Clean-claim
rate
- Net
collection rate
- Underpayment
rate
- Charge
capture
- Appeal
recovery
- Revenue
per encounter
- Top
five denial reasons
You do not need an expensive transformation project to
begin.
You need visibility.
Then you need a plan.
Then you need consistency.
About the Author
Dr. Daniel Cham is a physician-entrepreneur and
founder of OnnX, an AI-powered medical billing SaaS platform built
around a simple idea: small and medium-sized medical practices should have
better control, visibility and efficiency in their revenue cycle without
unnecessary layers of intermediaries.
His work sits at the intersection of medicine,
entrepreneurship, healthcare technology, artificial intelligence and practice
operations.
The goal is not to make physicians think more about billing.
It is to help them spend less time fighting the
administrative machinery surrounding the medicine they practice.
Disclaimer
This article is provided for general educational and
informational purposes and is not legal, medical, accounting, coding or
reimbursement advice.
Healthcare payment rules, payer policies, Medicare
requirements, CPT guidance and regulatory requirements can change. Physicians
and practice owners should consult qualified legal, compliance, coding,
accounting and reimbursement professionals regarding their individual
circumstances.
The discussion of Tennessee “Tenny” Maya and Reyanne Maya
is based on publicly reported information from FOX5 Las Vegas and is intended
to provide a human-interest context for the broader discussion. It should not
be interpreted as commentary on the medical care provided to the family.
Continue Connecting
You can continue the conversation through my professional
and educational channels:
Listen to the
podcast on Spotify
If this article is useful to you, please repost it.
One physician seeing this at the right time could change how
an entire practice thinks about its revenue cycle.
Recent Reading and Resources
FOX5 Las Vegas — Tenny Maya's story
A human-interest account of Reyanne Maya, her daughter Tennessee “Tenny” Maya,
Tenny's emergency birth, life-threatening intestinal condition, surgery and
95-day NICU stay. Read
the FOX5 story
American Medical Association — 2027 proposed Medicare fee
schedule
A current analysis of proposed 2027 Medicare physician payment changes,
including same-day E/M services and other reimbursement issues. Read
the AMA analysis
American Medical Association — Delays in Medicare reform
and prior authorization
AMA President Willie Underwood III, MD, discusses the consequences of payment
and prior-authorization barriers for physicians and patients. Read
the AMA commentary
American Academy of Family Physicians — Medical billing
and coding
Practical guidance covering coding accuracy, documentation, modifiers, payment
and revenue-cycle fundamentals. Read the
AAFP resource
AMA STEPS Forward — Small Workflow Changes Can Make a Big
Impact
A timely reminder that fixing small, high-friction workflow problems can create
meaningful improvements in physician work and organizational efficiency. Explore
the AMA resource
One Last Question
If you could eliminate one completely unnecessary
administrative task from your practice tomorrow, what would it be?
Leave your answer in the comments.
I suspect the answers would tell us more about the future of
healthcare than another thousand-page strategy document.
#Healthcare #MedicalBilling #PhysicianPractice #HealthcareAI
#RevenueCycleManagement #MedicalPracticeManagement #PhysicianEntrepreneur
#HealthcareTechnology #AIinHealthcare #MedicalCoding #HealthcareInnovation
#IndependentPractice #PhysicianLeadership #RevenueCycle #DigitalHealth
#PracticeManagement
