Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
Text-to-Pay and Online Patient Payments: What to Check Before You Sign a Vendor
Patient balances are a growing share of practice revenue and paper statements are the slowest way to collect them. Here is what we check before a practice signs a text-to-pay vendor: consent rules, HIPAA and card data scope, posting integration, fees, reconciliation and the four numbers that show whether it worked.
Preparing Front-Desk Collections for the January Deductible Reset
In January most patients owe the full visit cost until the deductible is met. Practices that collect at the desk in January collect it; practices that send statements in March mostly do not. Here is the fourth-quarter plan: deductible data from the eligibility response, estimates, card on file and scripts.
Medicare Open Enrollment Starts October 15: What Plan Exits Mean for Practices
Medicare open enrollment runs October 15 to December 7, 2026, and at least 33 health systems have left or are leaving Medicare Advantage networks while insurers trim their 2027 footprints. Here is what practices should expect in January and what to set up now at the front desk.
How to Benchmark Your Medical Practice Against Survey Data, Without the Traps
A practice owner reads that median days in AR is in the low thirties, sees 47 on her own report, and starts a fire drill. The survey measured something different. Here is how to benchmark your medical practice against survey data: the metrics, computing yours the survey's way, the specialty adjustments and the traps.
ICD-10-CM FY 2027 Takes Effect October 1: 190 New Codes and a Cutover Checklist
The FY 2027 ICD-10-CM update, with 190 new codes, 30 deletions and four revised titles, applies to all encounters on or after October 1, 2026. Here is what changed, the codes primary care and specialty practices will actually use, and the cutover checklist to run in the nine days that remain.
Why Completed Encounters Never Become Claims, and How to Catch Them Every Week
The most expensive leak in a medical practice is the visit that was seen, documented and never billed. Here is where unbilled encounters come from, how to measure the gap with three reports you already have, and the two weekly reconciliations that close it.
Building the Evidence File for PCMH Annual Reporting Under Standards 11.1
PCMH annual reporting is a documentation exercise, and the practices that struggle are the ones that start collecting evidence a month before the due date. Here is how we build the evidence file across the year under NCQA Standards Version 11.1, what changed in 2026, and the reports that satisfy reviewers.
NPI Type 1 vs Type 2: Rendering, Billing and the Setup Errors That Deny Claims
Every claim carries at least two provider identifiers, and when they are set up wrong the claim fails before anyone reads it. Here is how Type 1 and Type 2 NPIs work, where each goes on the claim, how reassignment and taxonomy codes tie them together, and the six setup errors behind most provider denials.
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