A Note from the Director of Billing & Reimbursement: Unlearning Is Harder Than Learning—Especially in Billing & Reimbursement

Published in Member Communities on July 13, 2026

By Stephanie Robinson, Director of Billing and Reimbursement, VGM & Associates

After 26 years on the supplier side, one thing stands out more than ever:

Learning something new is rarely the hardest part of this industry. It’s unlearning.

In DME, we build our knowledge over time—through experience, payer interactions, audits, denials, and what’s been passed down as “how it’s always been done.” That experience is incredibly valuable. But it can also quietly lock in habits and assumptions that don’t always keep up with changing guidance. And in billing and reimbursement, “outdated but familiar” can be just as risky as “unknown.”

Where This Shows Up Every Day

Long-held coverage assumptions:
- “Medicare has always paid this.”
- “We’ve billed it this way for years.”
- These aren’t wrong because they were never true; they’re risky because they may not be true anymore or may not apply in every scenario.
Policy interpretation drift:
- LCDs, payer manuals, and documentation requirements don’t always change dramatically—but how they’re interpreted over time can.
- Small shortcuts or “common understanding” can slowly replace what’s actually written.
Quick-answer culture:
- Texts, side conversations, and one-off emails feel efficient.
- But over time, they create inconsistency, limit visibility, and make it harder to identify patterns or correct misunderstandings.

Why Unlearning Matters

Unlearning isn’t about starting over—it’s about revalidating what we think we know.

That matters because it:

Reduces audit and recoupment risk
Strengthens consistency across teams
Ensures answers are defensible, not just familiar
Creates a stronger foundation for training and growth

In this space, confidence doesn’t come from how long we’ve done something—it comes from knowing it holds up today.

What Actually Helps

Over the years—and especially seeing common themes across suppliers—there are a few things that consistently make a difference:

Centralizing questions
- Having a single intake point (vs. scattered communication) creates:
  - Visibility into what’s being asked
  - Consistency in responses
  - The ability to track trends over time
- If three people are asking the same question in different ways, that’s not noise—that’s insight.
Getting comfortable asking, “Where is that written?”
- Not as a challenge—but as a standard.
- It shifts answers from opinion to policy.
Turning repeat questions into scalable education
- The same issues come up for a reason—coverage nuances, documentation gaps, payer confusion.
- Those are opportunities to create clarity once and apply it broadly.
Slowing down just enough to get it right
- Speed feels productive—but rework, denials, and appeals cost more time in the long run.
- A quick pause to validate can prevent bigger issues downstream.

The Reality

Unlearning is uncomfortable.

It means revisiting habits built over years.

It means acknowledging that something that “worked before” may not be the right approach today.

But in billing and reimbursement, that discomfort is often what protects you.

Final Thought

If learning builds expertise, unlearning keeps it accurate.

And in an environment where scrutiny is increasing and margins matter, accuracy isn’t just a compliance goal—it’s a business necessity.

If this resonates with what you’re seeing in your organization, I’d welcome the conversation. There’s a lot of value in sharing what’s working—and where we’re all being challenged to rethink the way we’ve always done things.

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