The Syntra
Blog.
Customer success stories, trends we're seeing across the industry, and the coding and compliance rules shaping specialty care.
CO-97 Denials: What to Check Before You Add Modifier 59
CMS’s October 2026 NCCI update changed PTP edit files. Use this workflow to review CO-97 adjustments before correcting, appealing, or writing them off.
84% of Health Insurers Use AI. Here's Where It Touches Your Claim.
Payer AI now reviews far more than denials. Here’s where algorithms enter the revenue cycle and how specialty practices can prepare.
The New Prior Authorization Scorecards: How to Compare Payers Using Their Own Data
CMS now requires many payers to publish approval, denial, appeal, and decision-time metrics. Here’s how specialty practices can use them.
CMS WISeR Is Live: Is Your Documentation Ready for AI-Assisted Prior Authorization?
CMS is testing AI-assisted review in Original Medicare across six states. Here’s what affected specialty practices should check before the next request.
How a 12-Provider Ophthalmology Group Recovered $340K in Missed Charges
A retroactive audit across 18 months of charts uncovered systematic undercoding in office visits and missed testing charges. Here’s how the practice turned that around.
What the 2026 E/M Guideline Updates Mean for Specialty Practices
CMS continues to refine medical decision making criteria. We break down the changes that matter most for specialty clinics and what to update in your coding workflows.
The State of AI in Revenue Cycle Management: What We’re Seeing in 2026
From pre-bill review to denial prediction, AI adoption in the revenue cycle has moved from pilot projects to production. Here’s where the industry actually stands.
Global Period Billing: The Compliance Trap Catching Orthopedic Practices
Modifier 24 and 25 misuse during global periods is one of the most common audit triggers we see. A practical guide to staying compliant without leaving revenue behind.
From 4% Audit Coverage to 100%: A Dermatology Group’s Compliance Story
Manual audits covered a fraction of this practice’s charts and lagged weeks behind. Here’s how they reached full coverage without adding headcount.
Payers Are Using AI to Deny Claims. Practices Need to Respond in Kind.
Denial rates are climbing as payers automate claim review. The practices holding their ground are the ones auditing charts before submission, not after denial.
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