Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
Sliding Fee Scales and Self-Pay Discounts: How to Set Them and Stay Compliant
Most practices give discounts to uninsured patients. Few have written down how. Here is how to build a sliding fee scale for a medical practice: the 2026 poverty guidelines, the tiers, the paperwork, the adjustment codes, and the payer contract and Medicare rules that decide whether a discount is a compliance problem.
MIPS 2027 Under the CY 2027 Proposal: New MVPs, Core Measures and a 2029 Sunset
Comments on the CY 2027 fee schedule proposal closed September 14, and the Quality Payment Program section is the part practices have read least. Here is what CMS proposed for MIPS 2027: three new MVPs, core measures, a changed Promoting Interoperability list and the end of traditional MIPS after 2028.
Medicaid Work Requirements Start January 2027: Preparing Your Front End
Under Public Law 119-21 and the CMS interim final rule issued June 1, 2026, states must apply an 80-hour monthly community engagement requirement to Medicaid expansion adults by January 1, 2027. Here is what it changes for eligibility, documentation and patient conversations in an independent practice.
Small-Practice Breach Response: The First 72 Hours and Who to Call
The IT vendor calls at 4:40 on a Friday: the files are encrypted. What the practice does in the next three days decides the cost of the next year. Here is a breach response plan for a small medical practice: containment, the call list in order, the incident log, the 60-day HIPAA clock and the risk assessment.
Telehealth Across State Lines: Licensure, Payer Rules and Compact Options
A video visit with a patient who is sitting in another state is practicing medicine in that state. Here is how we handle telehealth across state lines: where the license has to be, what Medicare, Medicaid and commercial plans require, the DEA rules for prescribing, and which licensure compacts are worth the paperwork.
Writing a CMS Comment That Gets Read: OPPS Closes August 31, PFS September 14
The CY 2027 OPPS comment period closes August 31, 2026 and the physician fee schedule period closes September 14. Most practices have never commented and assume it is pointless. It is not, but a useful comment looks different from an angry one. Here is the structure, three worked examples and the mistakes to avoid.
HIPAA Training for Medical Office Staff: Topics, Cadence and the Records to Keep
HIPAA training is required, but the rules say little about content, and most practices buy a video and file the certificates. We describe HIPAA training for medical office staff that matches a small practice's real risks: topics by role, scenarios that teach, the cadence and the records an investigator asks for.
How to Amend a Medical Record Correctly: Late Entries, Addenda and Corrections
Every practice fixes charts. The question is whether the fix survives a records review. We explain the three kinds of amendments, the Medicare rules for labeling and dating them, how to handle a patient's HIPAA amendment request, and the shortcuts that turn a documentation gap into a falsification problem.
Medical Record Signature Requirements: What Medicare Reviewers Accept and Reject
A missing or illegible signature can sink an otherwise perfect claim in a Medicare review. We explain the signature requirements for notes and orders, which electronic signature formats pass, when a signature log or attestation saves the claim, and the shortcuts that get records rejected.
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