Medical Management & Reimbursement Specialists, LLC

Medical Management & Reimbursement Specialists, LLC MRS provides coding, billing , software and billing services to hospitals and providers

A claim can be processed and paid without being reimbursed as expected.That creates a visibility gap denial reports may ...
09/02/2026

A claim can be processed and paid without being reimbursed as expected.

That creates a visibility gap denial reports may never reveal.

As payer review methods become more automated, healthcare leaders need to look beyond whether a claim was paid. They need to understand where reimbursement patterns are changing, why variances are occurring, and what those changes could mean for financial performance.

The question is no longer simply, “Did the claim pay?”

The better question is, “Did it pay as expected, and would we recognize if that began to change?”

Read this month’s message from Robin Ingalls-Fitzgerald.

https://www.mrsnh.com/

CMS Continues Moving Toward More Data-Driven ReimbursementWhile much attention has focused on artificial intelligence, a...
08/28/2026

CMS Continues Moving Toward More Data-Driven Reimbursement

While much attention has focused on artificial intelligence, another trend deserves equal attention: CMS continues modernizing Medicare payment systems with greater emphasis on automation, real-time analytics, payment integrity, and data-driven reimbursement oversight. These changes reflect a broader shift toward faster, more scalable claims processing and enhanced payment accuracy. Healthcare organizations should expect both public and private payers to continue investing in technologies that increase scrutiny of reimbursement decisions and accelerate the use of advanced analytics.

Your revenue data can tell you what happened.RevNav™ helps you understand what changed.By identifying reimbursement patt...
08/25/2026

Your revenue data can tell you what happened.

RevNav™ helps you understand what changed.

By identifying reimbursement patterns, payer trends, and paid-claim variances that deserve attention, RevNav™ helps healthcare leaders move from reviewing reports to taking informed action.

Because data alone does not protect financial performance. Knowing where to act does.

Ready to gain greater visibility into your reimbursement performance? Let’s start the conversation.

https://calendly.com/robin-68/coding-and-auditing-discovery-call

Most revenue cycle teams have spent years building sophisticated denial management programs.The problem?Not every reimbu...
08/21/2026

Most revenue cycle teams have spent years building sophisticated denial management programs.
The problem?
Not every reimbursement issue creates a denial.
As payer review methodologies become increasingly automated, healthcare organizations must begin treating paid claims as strategic financial intelligence rather than completed transactions.

Topics include:

- Why denial rates no longer tell the full story
- The false confidence created by "the claim paid"
- Reimbursement variance as an executive KPI
- Why Finance and Revenue Cycle should be reviewing the same data
- What high-performing organizations are doing differently
- How proactive paid-claim reviews protect margins before financial reports reveal problems

Read more: https://www.mrsnh.com/blog

HOT OFF THE PRESS: The 2027 Medicare Physician Fee Schedule proposal could bring significant changes to physician reimbu...
07/22/2026

HOT OFF THE PRESS: The 2027 Medicare Physician Fee Schedule proposal could bring significant changes to physician reimbursement.

CMS is proposing lower conversion factors for both qualifying APM participants and non-qualifying clinicians. But the broader revenue impact may come from proposed changes involving G2211, same-day E/M services during global periods, practice expense RVUs, ACO participation, and remote monitoring.

CMS is also requesting feedback on whether Medicare should move away from the AMA’s CPT code set, a change that could have far-reaching implications for coding, billing, technology, and reimbursement operations.

The strategic question is not simply, “How much will the conversion factor decrease?”

It is: How will the complete proposal affect our specific service mix, specialties, coding workflows, and net reimbursement?

Now is the time for revenue cycle, coding, compliance, finance, and operational leaders to review the proposal together, model its potential impact, and identify where workflows may need to change.

Public comments are due September 14, 2026.

Read more here: www.mrsnh.com/blog/2027-medicare-physician-fee-schedule-what-healthcare-leaders-need-to-know

Everyone is talking about how providers are using AI.We're watching something different.We're watching how payers are us...
07/14/2026

Everyone is talking about how providers are using AI.

We're watching something different.

We're watching how payers are using it.

As artificial intelligence becomes more sophisticated, reimbursement decisions are changing. Many organizations are focused on denial rates, but the bigger story may be hidden inside paid claims.

Healthcare leaders should begin asking a different question:

"How many paid claims were reimbursed differently than they should have been?"

That shift in thinking may define the next generation of revenue integrity.

At MRS, we're monitoring these emerging trends because visibility is no longer just an advantage. It's becoming essential.

Supporting Revenue Cycle Teams With Earlier VisibilityHealthcare revenue cycle teams are managing increasing operational...
07/10/2026

Supporting Revenue Cycle Teams With Earlier Visibility

Healthcare revenue cycle teams are managing increasing operational complexity across billing, coding, denials, authorizations, aging receivables, and payer communication.

At the same time, organizations are being asked to improve financial performance while operating under tighter margins and growing reimbursement pressure.

RevNav was designed to support experienced healthcare professionals by helping organizations identify operational patterns earlier across the revenue cycle.

RevNav does not replace revenue cycle teams.

It helps strengthen operational visibility so teams can make faster, more informed decisions before reimbursement issues escalate.

RevNav helps organizations evaluate:

Denial Trends
Payer Behavior
Aging Movement
Atb Performance
Reimbursement Slowdown
Reserve Exposure
Operational Bottlenecks
Financial Risk Indicators

All within a broader revenue visibility strategy.

By combining operational intelligence with human expertise, organizations may improve:

Reimbursement Timing
Financial Forecasting
Operational Prioritization
Reserve Planning Visibility
Denial Prevention Efforts
Staffing Efficienc

The goal is not simply reacting after revenue disruption occurs.

The goal is helping healthcare organizations recognize operational patterns earlier so financial impact can be reduced before reimbursement strain escalates.

Request a Complimentary Revenue Visibility Analysis

See how MRS helps healthcare organizations identify operational patterns earlier, strengthen financial visibility, and support revenue cycle teams with smarter operational insight.

Interested in gaining earlier visibility into the operational patterns impacting reimbursement performance? Schedule a RevNav demo to learn more.

Your claim was paid.But was it paid correctly?That's becoming one of the most important questions in revenue cycle today...
07/06/2026

Your claim was paid.

But was it paid correctly?

That's becoming one of the most important questions in revenue cycle today.

As payers expand their use of AI and automated claim review technologies, reimbursement decisions are changing. In many cases, claims aren't being denied. They're simply being paid at a lower level.

Because the claim still pays, these reductions often go unnoticed, quietly eroding revenue over weeks or even months.

In our latest MRS Insights, Robin Ingalls-Fitzgerald explores:

✔ Why paid claims deserve as much attention as denied claims.
✔ A real-world example of AI-driven payer downcoding.
✔ The questions every CFO and Revenue Cycle leader should be asking.
✔ Practical steps organizations can take to identify hidden reimbursement trends before they impact the bottom line.

If your organization hasn't taken a close look at paid claims recently, now is the time.

📖 Read the full article here: www.mrsnh.com/blog/thehiddentrend

Happy 250th, America.Wishing everyone a safe and meaningful Independence Day holiday from all of us at MRS.
07/03/2026

Happy 250th, America.

Wishing everyone a safe and meaningful Independence Day holiday from all of us at MRS.

The future of revenue cycle performance isn't about collecting more data.It's about identifying the right signals sooner...
07/02/2026

The future of revenue cycle performance isn't about collecting more data.

It's about identifying the right signals sooner.

As healthcare organizations continue navigating tighter margins, growing payer complexity, and increasing reimbursement pressure, the focus is shifting from reacting to problems to recognizing risk earlier.

The organizations gaining the strongest financial visibility are not necessarily the ones with the most reports. They are improving their ability to recognize meaningful operational patterns before reimbursement performance is affected.

Technology, automation, and emerging AI tools will continue evolving, but their greatest value will be supporting experienced healthcare professionals, not replacing them.

The future of revenue cycle performance lies in combining human expertise with smarter operational intelligence to strengthen decision-making, improve financial visibility, and identify reimbursement risk before it escalates.

Address

459 Lake Street Suite D
Bristol, NH
03222

Opening Hours

Monday 9am - 5pm
Tuesday 9am - 5pm
Wednesday 9am - 5pm
Thursday 9am - 5pm
Friday 9am - 5pm

Telephone

+18669914819

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