top of page
All Posts


Common Medical Billing Errors and How to Avoid Them
Claims pricing mistakes can be easy to make without the right technical support, and can cost your organization a pretty penny. Providers are up against increasing risk of financial consequences as medical billing continues to evolve. Small errors alone can lead to denied claims, compliance scrutiny, or delayed payments. These little errors add up to a huge financial loss! With complicated payer requirements, quick code updates, and high patient volumes, common mistakes conti

Micro-Dyn
6 days ago2 min read


US vs. International Healthcare Payment Systems: Lessons for American Providers
🌍 Introduction Healthcare financing has always been one of the most hotly debated issues in the United States. Despite being one of the wealthiest nations in the world, the U.S. consistently spends more on healthcare per capita than any other developed country but still struggles with affordability, accessibility, and administrative complexity. Meanwhile, nations like the United Kingdom, Germany, Canada, and Japan achieve better outcomes with more efficient and accessible sy

Micro-Dyn
Nov 124 min read


A Quick Glossary of Billing and Insurance Terms
If you’re new to claims pricing, seeking health insurance coverage for yourself, or trying to navigate a federal health insurance plan like Medicaid, the terminology can be overwhelming. Even if you're a healthcare provider or work in insurance policy, it can be tricky to track insurance acronyms and terms. In this short glossary of health insurance terms, we’ll be reviewing key phrases you should know. 📖 Here are some important terms for your insurance glossary: Advance B

Micro-Dyn
Oct 304 min read


Training New Staff on Complex Payment Methodologies: Best Practices
In the healthcare industry, payment accuracy is non-negotiable. Complex payment methodologies play a central role in revenue cycle management, regulatory compliance, and overall financial stability. Even small mistakes in claims processing or billing workflows can lead to costly denials, compliance risks, and dissatisfied patients. That’s why training new staff in payment methodologies is critical. Effective training ensures employees understand the nuances of medical paymen

Micro-Dyn
Oct 233 min read


HIPAA Compliance in Claims Pricing Software: Security Best Practices
In an increasingly digital world, healthcare is facing privacy challenges. The Health Insurance Portability and Accountability Act, or HIPAA, created legal standards for patient information privacy. When revenue cycle management is handled online, HIPAA must be carefully adhered to. Medical billing software for claims pricing is under more pressure to protect private health information. This protection is vital to maintain patient trust with protected health information and a

Micro-Dyn
Oct 153 min read


What CMS Web Pricer Can’t Do (And Why Third-Party Pricers Matter)
In the complex world of U.S. healthcare reimbursement, accuracy is everything. Providers rely on timely, correct pricing data to ensure optimal payments and avoid costly errors. For many, the CMS Web Pricer has long been a go-to tool. Offered publicly by the Centers for Medicare & Medicaid Services (CMS), it allows users to estimate payments across various Prospective Payment Systems (PPS). But while useful as a reference, the Web Pricer is far from a full-fledged solution. I

Micro-Dyn
Oct 83 min read


Top V28 Coding Pitfalls That Affect Risk Scores and Claims Pricer Accuracy
The CMS Hierarchical Condition Category (HCC) risk adjustment model plays a pivotal role in how Medicare Advantage (MA) plans reimburse...

Micro-Dyn
Oct 13 min read


How Claims Bundling Impacts Reimbursement Under OPPS & APCs
As outpatient care becomes a larger share of total healthcare delivery, understanding how claims bundling under the Outpatient...

Micro-Dyn
Sep 244 min read


Value-Based Care and Its Effect on Claims Grouping and Pricing
The healthcare industry’s move toward value-based care (VBC) has shifted the focus from volume to outcomes, fundamentally altering claims...

Micro-Dyn
Sep 184 min read


Avoiding Underpayments: How to Audit Your Claims Pricing Effectively
In today’s high-stakes healthcare reimbursement environment, underpayments are a silent threat to financial stability. Whether caused by...

Micro-Dyn
Sep 114 min read


Site-Neutral Payment Policies and Their Impact on Claims Pricing in 2025–2026
Medicare’s site-neutral payment policies are poised to be one of the most impactful reimbursement shifts for hospitals and ambulatory...

Micro-Dyn
Sep 44 min read


How AI is Transforming Claims Pricing Accuracy in 2025
In 2025, healthcare providers face unprecedented pressures—tightened margins, rising denial rates, and increasing regulatory complexity....

Micro-Dyn
Aug 283 min read


Building a V28-Compliant Coding Audit and Claims Pricing Program for 2025
As the Centers for Medicare & Medicaid Services (CMS) rolls out the V28 HCC risk adjustment model for 2025, healthcare providers and...

Micro-Dyn
Aug 213 min read


Training Clinical Teams on V28 Risk Adjustment and Claims Pricing in 30 Days
With CMS implementing the Version 28 (V28) update to its Hierarchical Condition Category (HCC) risk adjustment model, healthcare...

Micro-Dyn
Aug 143 min read


How the V28 HCC Model Reshapes Risk Capture and Claims Pricing for Primary Care Providers
The Centers for Medicare & Medicaid Services (CMS) has begun implementing the Version 28 (V28) Hierarchical Condition Category (HCC) model...

Micro-Dyn
Aug 63 min read


CY 2026 Medicare Advantage Policies and Their Impact on Claims Pricing and Reimbursement
The Centers for Medicare & Medicaid Services (CMS) recently released its CY 2026 Advance Notice for Medicare Advantage (MA) capitation...

Micro-Dyn
Jul 303 min read


The Role of Claims Pricer, Grouping, and Pricing in Modern Healthcare Revenue Cycles
In the complex ecosystem of healthcare billing and reimbursement, three technical yet mission-critical processes govern how services are...

Micro-Dyn
Jul 253 min read


From Claims Editing to Payment Integrity: What’s Changed in 2025
In 2025, the evolution from basic claims editing to holistic payment integrity is no longer a trend—it’s the new standard in healthcare...

Micro-Dyn
Jul 223 min read


The Hidden Costs of Outdated DRG Grouper Logic in 2025
Every hospital and health system knows that Diagnosis-Related Groups (DRGs) are foundational to Medicare reimbursement. But what often...

Micro-Dyn
Jul 104 min read


Understanding the 2026 Medicare Advantage Capitation Rates and Payment Policy Updates
On April 7, 2025, the Centers for Medicare & Medicaid Services (CMS) released its official 2026 Medicare Advantage (MA) Capitation Rates...

Micro-Dyn
Jul 33 min read
bottom of page
