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Billing often becomes one of the biggest administrative burdens for solo and small behavioral health practices. Behavioral health providers managing both clinical care and business operations face unique challenges: complex prior authorization requirements, extensive documentation standards, and insurance coverage barriers.
Esse Health has confirmed that 263,601 individuals have been affected by its April 2025 cyberattack. Louis area in Missouri, has recently notified the Maine Attorney General about an April 2025 cyberattack and data breach involving unauthorized access to the personal and protected health information (PHI) of 263,601 individuals.
adults with private health insurance between 2017 and 2019. Another finding: about 40% of all denials were due to billing errors by health care providers or processing mistakes by insurers—a reminder that many denials are not based on medical necessity or policy rules, but administrative mishaps.
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trillion in annual transactions, yet billing inefficiencies cost hospitals an estimated $262 billion each year. At the heart of this challenge lies the complex world of billing in hospital management systems, where accuracy, compliance, and efficiency determine the financial viability of healthcare organizations worldwide.
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There was a sizeable increase in the number of individuals affected by healthcare data breaches, which increased by 302% from May 2025. The high total is largely due to a phishing incident at a business associate that affected at least 25 cancer care and oncology practices. The median data breach size over the past 12 months is 4.7
Three months later, when longtime patients start calling about their insurance no longer covering visits, the physician finds out they have been dropped from multiple networks, not for quality issues but for missing a paperwork deadline. Insurance companies simply drop noncompliant providers and notify them after the fact. In practice?
On March 22, 2025, Compumedics identified unauthorized access to its network which disrupted the operations of its information technology systems. They confirmed that an unauthorized third party had access to its systems between February 15, 2025, and March 23, 2025, during which time files were copied from its systems.
An investigation was launched, and it was determined on January 21, 2025, that Ascension had inadvertently disclosed patient data to the former business partner, and that data had likely been stolen in the hacking incident.Ascension confirmed that its own systems were unaffected.
Northwest Radiologists & Mount Baker Imaging Northwest Radiologists and Mount Baker Imaging have provided an update on a data breach first announced in March 2025. The forensic investigation confirmed that there had been unauthorized network access between January 20, 2025, and January 25, 2025.
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Alpha Wellness and Alpha Medical Centre detected unusual network activity on February 3, 2025, and immediately launched an investigation. The compromised information included names, addresses, email addresses, phone numbers, health insurance information, and medical appointment information.
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On March 20, 2025, Pineland Community Service Board disclosed a security incident detected on January 20, 2025. The forensic investigation confirmed unauthorized network access between November 24, 2024, and January 20, 2025, during which time the threat actor viewed or copied information from its network.
Arlington Occupational Health and Wellness in Texas was added to the group’s data leak site on July 4, 2025, along with samples of the stolen data and links to the full dataset. The group claims to have published a huge variety of documents, including EMRs, test results, patient histories, and billing information.
We’re shifting our focus to the reports you should run regularly in 2025 to keep a pulse on your practice’s ongoing performance. By consistently monitoring these key areas, you can ensure operational efficiency, financial health, and compliance, ultimately enhancing the quality of care you provide to your patients.
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Do you know how to manage insurance claims to minimize denials and maintain your cash flow? Practice management skills like scheduling, billing, documentation, and compliance can protect you from professional burnout and set you on a path to success. But do you know how to set up an efficient scheduling system?
Industry data showed that insurers on HealthCare.gov denied about 19% of in-network claims in 2023 ; that’s $73 million out of $319 million in claims filed. For example, if you see a spike in denials from a particular insurer due to eligibility, you know exactly where to focus your front-end efforts.
Were shifting our focus to the reports you should run regularly in 2025 to keep a pulse on your practices ongoing performance. It categorizes unpaid patient invoices and insurance claims by age, typically in 30-day increments. They help you track the efficiency of your billing processes and identify potential bottlenecks.
Most denials trace back to the same handful of problems—wrong demographics, lapsed insurance, missing prior auth, lack of medical necessity or late filing. Reynolds Fact checked by Chris Mazzolini Blog Video Slash claim-denial headaches in 60 seconds with quick fixes to decode, prevent and overturn payer rejections—boosting cash flow fast.
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The affected individuals included employees and dependents of clients who used its services, which include HR outsourcing, benefits enrollment, billing, and administrative services. At the time of the initial announcement, Verisource Services said names, dates of birth, genders, and Social Security numbers had been stolen.
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The breach was detected on January 15, 2025, and immediate action was taken to prevent further unauthorized access. The forensic investigation confirmed that an unauthorized third party accessed the account between January 10, 2025, and January 14, 2025, and potentially viewed or acquired patient data.
Establishing medical necessity: The downstream importance of diagnosis codes Establishing a patient’s medical necessity is critical because it ensures that diagnostic tests, treatments and referrals are both clinically justified and reimbursable by insurance. were hospitalized.
The Bianlian hacking group claimed responsibility for the attack and gained access to names, Social Security numbers, addresses, dates of birth, driver’s license numbers, medical record numbers, health insurance information, billing information, and limited treatment information.
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