Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
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.
MIPS 2026 Year-End Checkpoints: What Must Be True by December 31
The 2026 MIPS performance year ends December 31, the threshold is 75 points and the penalty for missing it is up to 9 percent of 2028 Part B payments. Here is the September checkpoint list: performance periods that must already be running, data completeness, the security risk analysis and the submission window.
Closing Gaps in Care Before Year-End: Start the Outreach Push in September
Every quality program that pays your practice measures on a calendar year ending December 31, and this year patients are more likely than usual to change plans or lose coverage in January. Practices that run gap outreach from September through early December close more gaps. Here is the plan, step by step.
Interpreter Services in a Medical Practice: Legal Duties, T1013 and Who Pays
Practices must provide qualified interpreters to patients who need them, usually at their own expense. We lay out what Title VI, Section 1557 and the ADA require, who may and may not interpret, which Medicaid programs pay HCPCS T1013, the tax credit that offsets sign language costs, and a workflow that holds up.
Talking to Patients About 2027 Coverage Changes: Scripts, Letters and Timing
Marketplace insurers want a 15 percent median premium increase for 2027, Medicaid expansion adults face six-month renewals and work requirements, and deductibles reset in January. Patients will ask your staff what to do. Here is what to say, when to say it, and the four letters to have ready.
What to Include in an Eligibility Verification Workflow for Your Front Desk
Eligibility denials are the easiest denials to prevent and among the most common. A workflow that checks the right things at the right three moments, records what was checked, and gives the front desk a script for failures removes most of them. Here is what to include.
How to Bill a Sports Physical: Back-to-School Visits, Codes and Payer Rules
August fills the schedule with sports physicals, well-child visits and vaccine catch-up. Most of the write-offs we see in September come from mixing those three up on the claim. Here is how to bill a sports physical correctly, when to combine it with the annual well visit, and what to tell parents at check-in.
What Is a Work RVU? How Productivity and Medicare Payment Are Calculated
Work RVUs drive compensation formulas, productivity reports and every Medicare fee, and most physicians learn them by osmosis. We explain the three RVU components, the geographic adjustment and conversion factor, how a 99214 becomes a dollar amount, and where wRVU-based compensation goes wrong.
Billing Staff Productivity Benchmarks: Claims per FTE and Touches per Claim
Most practices measure billing staff by how busy they look. We lay out the numbers that actually describe a billing office, claims per FTE, touches per claim, denials resolved per day and posting speed, show how to pull them from your own system, and pair each with an accuracy measure so speed never beats correctness.
Page 1 of 4 · 30 articles
Want this level of attention on your own revenue cycle?
The same people who write these articles run billing, coding, denial management and credentialing for practices nationwide.