Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
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.
Common Credentialing Delays and How Practices Can Prepare for a New Provider
Most payer enrollment delays are caused before the application is submitted. Here is what payers reject, what they wait for, a realistic timeline by payer type, and the preparation checklist to start the day an offer is accepted.
Credentialing in September for January: Revalidations, Contracts, New Plans
January 1 is when payer contracts renew, plan networks change and revalidations that were ignored all year come due. Here is the September credentialing review we run for practices, with the checks, the deadlines and the file you should be able to produce for every provider.
Summer Credentialing: Fix the Enrollment Gaps You Will Pay for in January
July and August are when new physicians start, revalidations quietly come due and payer rosters drift out of date. The practices that treat summer as credentialing season avoid the January surprises: retroactive denials, held claims and providers who cannot bill the plans they see. Here is the summer checklist we run.
Credentialing Terms Explained: CAQH, PECOS, NPPES, Delegation, Effective Dates
Credentialing has its own vocabulary, and a physician who does not know it cannot tell whether a delay is normal or a problem. This glossary explains the thirty terms that come up in every enrollment, from NPPES and PECOS to primary source verification, delegated credentialing and retroactive effective dates.
Credentialing Summer Hires: The Timeline for Providers Starting in July 2026
Residency ends in June, and new physicians start in July and August. If their credentialing did not begin in March, they will see patients whose claims cannot be billed. Here is the realistic timeline for Medicare, Medicaid and commercial payers, what to do when it is already late, and how to bill during the gap.
Practice Acquisition Billing: New TIN, Enrollment Sequencing and No Payment Gap
When a practice is bought or merged, the clinical work continues on day one but payments often stop for two or three months. We lay out practice acquisition billing step by step: asset versus stock deal, new TIN and NPI, Medicare 855B and reassignments, commercial contracts, old AR run-out and a 120-day timeline.
Spring Credentialing Revalidations: PECOS Due Dates and CAQH Attestations
Medicare revalidation notices, CAQH re-attestations and commercial recredentialing cycles tend to pile up in spring. Here is how to read the PECOS revalidation list, what a deactivation actually costs, the 120-day CAQH rhythm, and a tracking sheet that keeps a multi-provider practice from missing one.
Provider Offboarding Checklist: Reassignment, Payer Notices and the 30-Day Trap
When a physician leaves, the practice has 30 days to tell Medicare, payer contracts with their own notice clauses, and months of claims that still need to pay. Our provider offboarding checklist covers enrollment terminations, reassignment end dates, forwarding claims and the notice deadlines practices miss.
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