Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
Responding to a Medicare Targeted Probe and Educate Review: The Three Rounds
A Targeted Probe and Educate letter from your Medicare contractor starts a process with up to three rounds of 20 to 40 claims, an education session after each, and a referral to CMS if you fail all three. Here is how the rounds work, what the error rate means, and how to close the review out in round one.
MIPS 2024 Data Preview Closes June 11, 2026; PI Window Must Start by July 5
Two MIPS dates land in the next five weeks. Physicians can preview their 2024 MIPS performance data before it is posted on Medicare.gov compare until June 11, 2026, and the 2026 Promoting Interoperability 180-day window must begin by July 5. Here is what to check in each.
What the OIG Is Auditing in Physician Practices in 2026: Incident-To and CCM
The HHS Office of Inspector General published a report on office-based vascular procedures on May 4, 2026, has an active national audit of incident-to billing, and added a chronic care management audit in March. We explain what each one is looking for and how a practice checks itself before someone else does.
OCR's April 2026 Ransomware Settlements Share One Finding: No Risk Analysis
On April 23, 2026 OCR announced four HIPAA settlements totaling $1,165,000, all following ransomware attacks and all citing a missing or inadequate risk analysis. April's breach report also shows 47 large breaches and 1.3 million people affected. Here is what a small practice should do about it, and how long it takes.
HIPAA at the Front Desk: Sign-In Sheets, Phone Calls and Minimum Necessary
Most HIPAA problems in a small practice happen at the front desk, not in the server room. We cover what the Privacy Rule actually allows for sign-in sheets, waiting room conversations, phone verification, voicemail, faxes and family members, with a table of common situations and the compliant habit for each.
Waiving Copays and Professional Courtesy: What the Anti-Kickback Statute Allows
Waiving copays for colleagues, staff, friends or struggling patients feels generous and is often illegal. We explain how the Anti-Kickback Statute, the beneficiary inducement rules, the Stark professional courtesy exception and payer contracts treat waivers, and how to write a hardship policy that holds up.
Compliance Program for a Small Medical Practice: The Seven Elements, Year One
A compliance program for a small medical practice does not need a department. It needs the seven OIG elements scaled to your size, a realistic first-year calendar and a folder of documents you can hand to an auditor. Here is what we set up, in what order, and what to keep.
Open Payments Review Opens April 1, 2026: What Physicians Should Check by May 15
From April 1 to May 15, 2026 physicians, PAs and NPs can review the payments drug and device companies reported about them for 2025 before CMS publishes the data on June 30. What Open Payments is, why records are often wrong, how to register and dispute, and the practice policy that keeps next year's list short.
The HIPAA Security Rule Update Is Still Pending: What to Do While You Wait
HHS proposed the biggest rewrite of the HIPAA Security Rule in two decades in January 2025. As of March 2026 there is still no final rule. Here is what the proposal would require, why waiting for it is a mistake, and the seven steps a practice can take this spring that will be needed under any version.
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