The Pulse by Peregrine
Actionable insights. Smarter systems. Better revenue.
Fourth Quarter Checkup
Q4 is here and now is your last opportunity to clean up claims, close care gaps, and strengthen your revenue cycle before 2026 policy updates hit.
Unworked denials and aging A/R quietly eat into your profitability.
Now’s the time to audit open claims, track unresolved denials, and re-engage payers before balances age out and become uncollectible.
Q4 is the ideal time to identify underpayments, update payer contracts, and retrain staff on new E/M and modifier rules. Tighten your processes, review contract rates, and ensure your team is billing accurately under the latest documentation and coding updates.
Preparing now helps you start January strong, not scrambling to fix 2025’s mistakes. Close the year with clean books, clear data, and confidence that your revenue cycle is built for a smooth 2026 transition.
Schedule Your Free Year End Revenue Cycle Audit ➜
Partner Checkup… Beyond Billing
Already a Peregrine client?
Q4 is the ideal time for a strategic checkup, not just a billing review.
We’ll focus on:
- Year-over-year collection trends
- Upcoming payer and compliance changes that could impact your specialty
- Workflow efficiencies to reduce touches and boost productivity
That’s what it means to have a true partner in your success, one who keeps you prepared, compliant, and ahead of every change.
Let’s close the year strong, together. Connect with your Peregrine representative to schedule your year-end strategy review.
Schedule My Complimentary Review ➜
Featured Insights…
Policy Update: CMS Claims Hold Now in Effect
CMS has directed all Medicare Administrative Contractors (MACs) to temporarily hold claims with dates of service on or after October 1, 2025, for services impacted by expired Medicare payment provisions. This includes Physician Fee Schedule, ground ambulance, and FQHC claims.
In addition, pre-pandemic Medicare telehealth restrictions have resumed for non-behavioral services, limiting coverage to rural areas, removing home-based visits, and reinstating in-person requirements for hospice recertifications.
Providers can continue submitting claims, but payments will not be released until the hold is lifted.
Read the full update and guidance →
What Practices Should Do Now
- Continue submitting claims but expect payment delays.
- Monitor Congressional updates closely.
- Review your telehealth policies and ABN procedures.
- Communicate with your billing team or Peregrine representative to ensure proper handling of held claims.
This Month’s Freebie:
📊 The Cost of Ignoring Denials
- The average denial costs $118 to rework, and 65% are never appealed.
- Review your denial patterns before year-end💡most are preventable with correct coding, eligibility checks, and proper documentation.
Learn more in our Denial Prevention Guide →
Quick Reads
- Capture Modest but Meaningful Revenue with CPT 98966
- G2211 Complexity Add-On Code, capture an extra $90K annually
- Aetna & Cigna Reimbursement Policy Updates thru year-end Read More ➜
- UHC Reimbursement Policy Updates thru year-end
- Prior Authorization and Pre-Claim Review: What ASC Providers Need to Know
- 2026 ICD-10 updates take effect on October, 1st. Check out the latest ICD-10 Coding Books
- Visit our Practice Support Center where we our experts handle scheduling, eligibility, authorizations, referrals & collections
Don’t miss these practice-critical updates, all in one place.
Peregrine Breakroom
RCM Humor Corner
Q: Why did the claim go to therapy?
A: Too many unresolved denials.
Behind the Screens
Each month, our team shares one quick win from the field:
“This month we helped a cardiology group recover $42,000 in denied cath lab claims all due to a missing modifier.”
Real stories. Real recoveries. Real revenue.
What’s your favorite part of Q4?
Pumpkin spice everything
Year-end performance bonuses
Fewer patient no-shows
Finally taking vacation time
(We’ll let you guess which answer our billing team picked…)