CombineHealth Blogs

Caral Edelberg

Caral Edelberg is the Founder and Chairman of Edelberg & Associates. With over 40 years of experience in medical coding, auditing, and compliance, she has helped shape national standards in emergency medicine. She has served on advisory boards for the AAPC and ACEP, which honored her with an Honorary Membership for her contributions to the specialty.

Latest news & articles by Author

Upcoding And Downcoding: Key Differences, Risks & Prevention

Learn the differences between upcoding and downcoding in medical billing. Understand financial impacts, legal risks, and how AI ensures coding accuracy.

MIPS Healthcare: What It Is, Why It Costs You Money, and How to Implement It Effectively

Discover what MIPS Healthcare is, why it impacts your Medicare reimbursements, and how to implement it effectively to avoid penalties and maximize performance.

Orthopedic Medical Billing Guide: Challenges and Strategies for RCM Teams

Discover how medical billing for orthopedic practices works, the key challenges involved, and strategies RCM teams can use to reduce denials and boost revenue.

Value-Based Care in Healthcare: A Comprehensive Guide

Discover what value-based care in healthcare means, how it compares to fee-for-service, and what it takes to make the transition.

AI Governance in Healthcare: How To Ensure a Safe, Ethical, and Effective AI Implementation for Your Organization

Discover how AI governance helps healthcare organizations reduce risks like bias, errors, and data breaches while improving trust and compliance

How To Appeal an Insurance Claim Denial: A Provider’s Guide

Discover the step-by-step process for appealing denied insurance claims and understand when a corrected claim is better than an appeal.

Common Claim Denial Codes and What They Each Mean

Understand why medical claims are denied by payers, learn the common claim denial codes, and discover how payers communicate these reasons.

8 Tough Questions to Ask While Evaluating an AI RCM Billing and Coding Solution

Wondering which AI RCM billing and coding solution is the right fit for your healthcare organization? Check out this guide to understand the questions you should ask to evaluate a vendor before making the final decision.

Claim Denial 101: Top Reasons You’re Getting Denied and How to Turn It Around

Understand why claim denials happen in healthcare and what to make of the denial codes communicated by payers. Also, explore how AI-powered denial management can help get faster reimbursements and avoid denials altogether.

5 Silent Revenue Killers in Your FQHC Billing Process

FQHCs often lose revenue to hidden gaps in billing and documentation. This post reveals five silent revenue killers in FQHC billing and how AI can help fix them fast.

One Big Beautiful Bill Act: 6 Key Takeaways for FQHCs

Understand the OBBBA’s impact on FQHCs—Medicaid cuts, work requirements, and coverage loss. Adapt by strengthening outreach, improving billing systems, partnering locally, and embracing tech to reduce admin and financial strain.

Medical Billing And Coding Salaries in 2025: What to Expect

Curious about where medical coding and billing salaries are headed in 2025? This post breaks down average pay, top-paying states, growth trends, and what’s impacting compensation.

2025 Buyer’s Guide for CDI Software: Key Features, KPIs, and Selection Tips

Can't make up your mind on which CDI software to invest in? Check out our comprehensive guide to understand the features to look for and the KPIs to track to find the perfect match for your CDI efforts.

What Is Medical Coding? A Strategic Asset For Clinics And Billing Companies

Medical coding is what keeps clinics running and revenue flowing. Discover how AI tools like Amy are reshaping coding, cutting denials, and helping teams focus on care, not claims.

Independent Interpretation Explained: Why It Matters For Your CDI and How To Get It Right

Independent interpretation is the key to accurate coding and stronger MDM. This blog explains what it is, why it matters, and how getting it right can protect your revenue and clean up your CDI.

A Complete Guide to Clinical Documentation Improvement Software: Workflow, Benefits, and Real-World Use Cases

Think one missing detail won’t hurt your claim? This blog reveals how small documentation gaps can lead to costly claim denials and how AI-powered clinical documentation improvement software can help flag them.

Medical Coding Salary Benchmarks: What Medical Coding Professionals Need to Know in 2025

Medical coding salaries in 2025 are driven by demand for skilled professionals and evolving payer regulations. This guide breaks down current benchmarks, factors affecting pay, and how coders can future-proof their careers.

AI in Medical Billing and Coding Processes - The Ultimate Guide for 2025

Medical Coding Audits: Benefits for Healthcare Practices

ICD-10 Explained: A Comprehensive Guide to Medical Coding

‍What is ICD 11? International Classification of Diseases 11th Revision

Credentialing in Healthcare Explained: Process, Challenges and Benefits

The Benefits of HCC Coding in Healthcare

Medical Coding for Pediatric Care: Your Practical Guide to Cleaner Claims and Faster Payments

Not sure which medical codes are relevant for pediatric care and how they're different from general coding guidelines? Explore the nuances of pediatric coding in this blog post and get the reference list of codes to be used in different pediatric settings.

CPT Codes For Mental Health Billing

HCPCS Codes: A Complete Guide

Medical Coding for Emergency Rooms: All You Need to Know

Learn how emergency room medical coding works, why accuracy is critical for care and reimbursement, and how AI supports overburdened ER teams.
Medical coding and AI - CombineHealth

Utilizing AI to navigate ever-changing medical coding guidelines | CombineHealth