Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
What an RCM Audit Should Actually Evaluate, and What the Report Should Contain
A useful revenue cycle audit follows the money from the appointment book to the bank deposit. If the report does not include unbilled encounters, submission lag and a remittance sample, it is a sales call with a spreadsheet. Here are the seven components and how to read the findings.
Prior Authorization Turnaround Tracking: The Log That Wins Appeals
Since January 1, 2026, Medicare Advantage, Medicaid managed care and Marketplace plans must decide most prior authorizations within seven days, or 72 hours when expedited. Practices that log every request against those clocks win appeals and have data for payer meetings. Here is the log, field by field.
Loading Your 2026 Fee Schedules to Catch Underpayments Before Year-End
You cannot find an underpayment without knowing what the correct payment was. Half of 2026 has been paid at rates most practices never loaded. Here is how to load Medicare's two 2026 conversion factors and your commercial contracts, run a variance report, and recover what payers owe before the contract year closes.
Pre-Service Financial Clearance for Procedures: Verify, Estimate, Collect
Pre-service financial clearance means knowing, before the patient arrives for a procedure, that coverage is active, authorization is in hand and the patient knows what they owe. Here is the timeline, the benefit fields to read, a worked estimate and the script that collects it.
Revenue Cycle KPIs Explained for Physicians: Clean Claim Rate, Days in AR, More
Most practice owners get a monthly report full of revenue cycle KPIs and trust none of them. This glossary explains the ten that matter, gives the formula for each, the commonly quoted benchmark, the way each one gets gamed, and a worked example from a four-provider practice.
A Small Balance Write-Off Policy for a Medical Practice: What to Put in Writing
Every practice writes off small balances; few have a policy that says which ones, who approves it and how it is reported. We lay out the adjustment types a small balance write-off policy should define, the thresholds that work, the Medicare rules that limit routine waivers and the monthly report that catches leakage.
First-Quarter 2026 Revenue Review: The Eight Numbers to Pull Before April Starts
March is when the January payer and fee schedule changes show up in real remittances. Here are the eight numbers we pull for every practice at the end of Q1, how to read each one against the 2026 Medicare conversion factor and the January deductible reset, and what a bad number usually means.
MIPS Payment Adjustments on 2026 Medicare Remits: CARC 144, 237 and Remark N807
Since January 1, every Medicare Part B remit carries the result of your 2024 MIPS score, as a small increase or a cut of up to nine percent. We explain how the 2026 MIPS payment adjustment appears on the remit, how to verify it against your final score, and what to do if the numbers disagree.
Payment Posting Workflow: Auto-Posting, Manual Posting and Daily Deposit Match
Every report in the billing office is built from posted payments, so late or wrong posting makes every report wrong. We lay out the payment posting workflow we set up: 835 auto-posting rules that don't hide denials, manual posting with control totals, and the daily match of posted batches to bank deposits.
Page 1 of 3 · 23 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.