Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
Medicaid Unwinding Is Ending: How to Stop Losing Visits to Terminated Coverage
Most states have finished or nearly finished their first round of Medicaid renewals, and more than 20 million people have been disenrolled since April 2023, most of them for paperwork reasons. Here is how the losses show up in a practice's denials and the eligibility routine that stops them.
How to Build a Claims Contingency Plan for a Clearinghouse Outage
A week into the Change Healthcare outage, most practices are discovering they have no plan for a clearinghouse failure. Here is how to write one: the dependency map, a second submission route, eligibility and remittance fallbacks, the cash reserve and the daily count that keeps claims from aging out.
Charge Capture Inside the Visit: The Injections and Tests That Go Unbilled
The visit was billed, but the injection, the point-of-care test and the depression screening were not. This kind of leakage hides inside encounters that look complete. Here is where it happens, a table of commonly missed services, and the weekly reconciliation that catches it.
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The same people who write these articles run billing, coding, denial management and credentialing for practices nationwide.